It Is Time to Focus on “Segmental Remodeling” with Validated Biomarkers as “Stressed Heart Morphology” in Prevention of Heart Failure

Yalçın, Fatih; García, Mario J.

doi:10.3390/jcm11144180

Cited by 3 publications

(8 citation statements)

References 13 publications

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“…These findings could assist in effective time management during the course of disease [30]. The current investigations point out the detected early imaging biomarkers could be used for preventing the increasing incidence of cardiac pathologies with LV remodeling and undiagnosed heart failure [31]. Histopathologic analysis of the septal base has shown differences between no fiber disarray and hypertrophic cardiomyopathy [32].…”

Section: Cardiac Manifests Of Stressmentioning

confidence: 81%

The Science Behind Stress: From Theory to Clinic, Is Basal Septal Hypertrophy the Missing Link between Hypertension and Takotsubo Cardiomyopathy?

Çağatay,

Yalçin,

Kıraç

et al. 2024

Stresses

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The modern theory of stress, initially proposed by Hans Selye in 1956, signifies an important development in our understanding of this phenomenon. Selye’s The Stress of Life serves as a foundational book for subsequent scientific questions. In this article, we focus on a comprehensive look at stress and use a literature review to explain its theoretical foundations as well as its clinical equivalent. Our research focuses on the complex mechanisms of stress, with a particular emphasis on the consequences of cardiac remodeling and adaptation processes. Myocardial remodeling might be seen as a response to increased stress in acute or chronic situations. Stressed heart morphology (SHM) is a very interesting description representing basal septal hypertrophy (BSH), which is detectable in both acute emotional stress and chronic stress due to increased afterload in hypertension. Acute stress cardiomyopathy (ASC) and hypertension in the same individuals could be clinically linked. Also, in this report, we mention the geometric and functional similarity of the left ventricle (LV) septal base in both acute and chronic clinical situations. Therefore, cardiac imaging methods are crucial to assessing LV segmental aspects in ASC patients. We propose a new paradigm that ASC may develop in hypertensive patients with SHM. We document the segmental progression of microscopic LV remodeling using a third-generation microscopic ultrasound and note that BSH takes a longer time to occur morphologically than an acutely developed syndrome. However, the majority of ASC events have a predominant base, and the absence of segmental remodeling details, including BSH and cardiac decompensation with apical ballooning, on echocardiographic reports may mask the possible underlying hypertensive disease. In fact, beyond ASC cases, previously undiagnosed hypertension is very common, even in developed countries, and is associated with masked target organ damage.

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Section: Cardiac Manifests Of Stressmentioning

confidence: 81%

The Science Behind Stress: From Theory to Clinic, Is Basal Septal Hypertrophy the Missing Link between Hypertension and Takotsubo Cardiomyopathy?

Çağatay,

Yalçin,

Kıraç

et al. 2024

Stresses

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“…Such changes are usually considered physiological in elite athletes, but they may also hide a pathological substrate. Therefore, their interpretation is the key in distinguishing them from underdiagnosed pathological situations, such as the early stages of heart failure [21].…”

Section: Early Imaging Biomarker Stressed Heart Morphology (Shm) As T...mentioning

confidence: 99%

Cardiac Biomarkers in Sports Cardiology

Costache

Leon‐Constantin

Roca

et al. 2022

JCDD

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Sustained physical activity induces morphological and functional changes in the cardiovascular system. While mostly physiological, they can also become a trigger for major adverse cardiovascular events, the most severe of which are sudden cardiac arrest and sudden cardiac death. Therefore, any novel method which can help more accurately estimate the cardiovascular risk should be considered for further studying and future implementation in the standard protocols. The study of biomarkers is gaining more and more ground as they have already established their utility in diagnosing ischemic cardiac disease or in evaluating cardiac dysfunction in patients with heart failure. Nowadays, they are being implemented in the screening of apparently healthy individuals for the assessment of the cardiovascular risk. The aim of this paper is to gather published data regarding the measurements of cardiac biomarkers in athletes, i.e., troponins, myoglobin, CK-MB, NT-proBNP, and D-Dimers, and their potential use in the field of sports cardiology.

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“…The dominant role of the type of stress is not known in SHM, since there is a lack of the pooled data regarding segmental remodeling around the world as we recently have pointed out in our editorial [31]. 6.…”

mentioning

confidence: 96%

“…Segmental remodeling, namely, SHM could be implemented in a clinical protocol for monitoring previously undiagnosed hypertension and increased stress [9,[30][31][32].…”

mentioning

confidence: 99%

“…Segmental LV remodeling instead of cross-sectional measurements could contribute to the prediction of future global LV remodeling and heart failure development due to basal apical discordance as we have recently proposed in patients with mechanic stress in aortic stenosis and functional stress in hypertension due to increased afterload, respectively [25,[30][31][32]. 5.…”

mentioning

confidence: 99%

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Stress and Heart in Remodeling Process: Multiple Stressors at the Same Time Kill

Yalçin,

Abraham,

Garcia

2024

JCM

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Myocardial remodeling is developed by increased stress in acute or chronic pathophysiologies. Stressed heart morphology (SHM) is a new description representing basal septal hypertrophy (BSH) caused by emotional stress and chronic stress due to increased afterload in hypertension. Acute stress cardiomyopathy (ASC) and hypertension could be together in clinical practice. Therefore, there are some geometric and functional aspects regarding this specific location, septal base under acute and chronic stress stimuli. The findings by our and the other research groups support that hypertension-mediated myocardial involvement could be pre-existed in ASC cases. Beyond a frequently seen predominant base, hyperkinetic tissue response is detected in both hypertension and ASC. Furthermore, hypertension is the responsible factor in recurrent ASC. The most supportive prospective finding is BSH in which a hypercontractile base takes a longer time to exist morphologically than an acutely developed syndrome under both physiologic exercise and pressure overload by transaortic binding in small animals using microimaging. However, cardiac decompensation with apical ballooning could mask the possible underlying hypertensive disease. In fact, enough time for the assessment of previous hypertension history or segmental analysis could not be provided in an emergency unit, since ASC is accepted as an acute coronary syndrome during an acute episode. Additional supportive findings for SHM are increased stress scores in hypertensive BSH and the existence of similar tissue aspects in excessive sympathetic overdrive like pheochromocytoma which could result in both hypertensive disease and ASC. Exercise hypertension as the typical form of blood pressure variability is the sum of physiologic exercise and pathologic increased blood pressure and results in increased mortality. Hypertension is not rare in patients with a high stress score and leads to repetitive attacks in ASC supporting the important role of an emotional component as well as the potential danger due to multiple stressors at the same time. In the current review, the impact of multiple stressors on segmental or global myocardial remodeling and the hazardous potential of multiple stressors at the same time are discussed. As a result, incidentally determined segmental remodeling could be recalled in patients with multiple stressors and contribute to the early and combined management of both hypertension and chronic stress in the prevention of global remodeling and heart failure.

show abstract

It Is Time to Focus on “Segmental Remodeling” with Validated Biomarkers as “Stressed Heart Morphology” in Prevention of Heart Failure

Abstract: In cardiovascular medicine, hemodynamic stress with hypertension is a major risk [...]

Cited by 3 publications

References 13 publications

The Science Behind Stress: From Theory to Clinic, Is Basal Septal Hypertrophy the Missing Link between Hypertension and Takotsubo Cardiomyopathy?

The Science Behind Stress: From Theory to Clinic, Is Basal Septal Hypertrophy the Missing Link between Hypertension and Takotsubo Cardiomyopathy?

Cardiac Biomarkers in Sports Cardiology

Stress and Heart in Remodeling Process: Multiple Stressors at the Same Time Kill

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