Myocardial response to biomechanical stress

Biomechanical stress of the myocardium is the situation resulting from hypo xia, hypertension, and other forms of myocardial injury, that invariably le ad to increased demands for cardiac work and/or toss of functional myocardi um. As a consequence of biomechanical stress a number of responses develop involving all the myocardial cells, namely cardiomyocytes. As a result some myocardial phenotypic changes develop that are initially compensatory (i.e ., hypertrophy) but which may mediate the eventual decline in myocardial fu nction that occurs with the transition from hypertrophy to failure in condi tions of persistent stress (i.e., apoptosis and fibrosis). This review focu ses on the steps involved in the response of the myocardium to biomechanica l stress and highlights the most recent developments in the molecular mecha nisms involved in the development of heart failure.