IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305165
Open Access Review
Cardiac Hypertrophy: From Pathophysiological Mechanisms to Heart Failure Development
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1 Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, I-80138 Naples, Italy
2 Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, I-80138 Naples, Italy
*Correspondence: (Ferdinando Carlo Sasso)
These authors contributed equally.
Academic Editor: Maurizio Pieroni
Rev. Cardiovasc. Med. 2022, 23(5), 165;
Submitted: 31 December 2021 | Revised: 23 February 2022 | Accepted: 28 February 2022 | Published: 6 May 2022
(This article belongs to the Special Issue Cardiac Hypertrophy: from Basic Science to Clinical Application)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Cardiac hypertrophy develops in response to increased workload to reduce ventricular wall stress and maintain function and efficiency. Pathological hypertrophy can be adaptive at the beginning. However, if the stimulus persists, it may progress to ventricular chamber dilatation, contractile dysfunction, and heart failure, resulting in poorer outcome and increased social burden. The main pathophysiological mechanisms of pathological hypertrophy are cell death, fibrosis, mitochondrial dysfunction, dysregulation of Ca2+-handling proteins, metabolic changes, fetal gene expression reactivation, impaired protein and mitochondrial quality control, altered sarcomere structure, and inadequate angiogenesis. Diabetic cardiomyopathy is a condition in which cardiac pathological hypertrophy mainly develop due to insulin resistance and subsequent hyperglycaemia, associated with altered fatty acid metabolism, altered calcium homeostasis and inflammation. In this review, we summarize the underlying molecular mechanisms of pathological hypertrophy development and progression, which can be applied in the development of future novel therapeutic strategies in both reversal and prevention.

cardiac hypertrophy
heart failure
diabetic cardiomyopathy
Fig. 1.
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