Epigenetic mechanisms are fundamental in cardiac adaptations, remodeling, reverse
remodeling, and disease. A primary goal of translational cardiovascular research is
recognizing whether disease related changes in phenotype can be averted by eliminating or
reducing the effects of environmental epigenetic risks. There may be significant medical
benefits in using gene-by-environment interaction knowledge to prevent or reverse organ
abnormalities and disease. This survey proposes that “environmental”
forces associated with diastolic RV/LV rotatory flows exert important, albeit still
unappreciated, epigenetic actions influencing functional and morphological cardiac
adaptations. Mechanisms analogous to Murray's law of hydrodynamic shear-induced
endothelial cell modulation of vascular geometry are likely to link diastolic
vortex-associated shear, torque and “squeeze” forces to RV/LV adaptations.
The time has come to explore a new paradigm in which such forces play a fundamental
epigenetic role, and to work out how heart cells react to them. Findings are considered
from various disciplines, imaging modalities, computational fluid dynamics, molecular cell
biology and cytomechanics. Examined are, among others, structural dynamics of myocardial
cells (endocardium, cardiomyocytes, and fibroblasts), cytoskeleton, nucleoskeleton, and
extracellular matrix, mechanotransduction and signaling, and mechanical epigenetic
influences on genetic expression. To help integrate and focus relevant pluridisciplinary
research, rotatory RV/LV filling flow is placed within a working context that has a
cytomechanics perspective. This new frontier in contemporary cardiac research should
uncover versatile mechanistic insights linking filling vortex patterns and attendant
forces to variable expressions of gene regulation in RV/LV myocardium. In due course, it
should reveal intrinsic homeostatic arrangements that support ventricular myocardial
function and adaptability.