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Involvement of nuclear factor-kappaB and apoptosis signal-regulating kinase 1 in G-protein-coupled receptor agonist-induced cardiomyocyte hypertrophy.

BACKGROUND: Recently, reactive oxygen species (ROS) have emerged as important molecules in cardiac hypertrophy. However, the ROS-dependent signal transduction mechanism remains to be elucidated. In this study, we examined the role of an ROS-sensitive transcriptional factor, NF-kappaB, and a mitogen-activated protein kinase kinase kinase, apoptosis signal-regulating kinase 1 (ASK1), in G-protein-coupled receptor (GPCR) agonist (angiotensin II, endothelin-1, phenylephrine)-induced cardiac hypertrophy in isolated rat neonatal cardiomyocytes. METHODS AND RESULTS: Using an ROS-sensitive fluorescent dye, we observed an increase in fluorescence signal on addition of the GPCR agonists. The GPCR agonists induced NF-kappaB activation. Antioxidants such as N-acetyl cysteine, N-mercaptopropionyl glycine, and vitamin E attenuated the NF-kappaB activation. Infection of cardiomyocytes with an adenovirus expressing a degradation-resistant mutant of IkappaBalpha led to suppression of the hypertrophic responses. The GPCR agonists rapidly and transiently activated ASK1 in a dose-dependent manner. Infection of an adenovirus expressing a dominant-negative ASK1 attenuated the GPCR agonist-induced NF-kappaB activation and cardiac hypertrophy. Overexpression of a constitutively active mutant of ASK1 led to NF kappaB activation and cardiac hypertrophy. Activated ASK1-induced hypertrophy was abolished by inhibition of NF-kappaB activation. CONCLUSIONS: These data indicate that GPCR agonist-induced cardiac hypertrophy is mediated through NF-kappaB activation via the generation of ROS. ASK1 is involved in GPCR agonist-induced NF-kappaB activation and resulting hypertrophy.

Angiotensin II↗

Calcineurin inhibition attenuates mineralocorticoid-induced cardiac hypertrophy.

BACKGROUND: It remains unclear how mineralocorticoids induce cardiac hypertrophy and fibrosis. Recently, activation of the calcium-dependent phosphatase, calcineurin, has been shown to induce cardiac hypertrophy. In the present study, we examine the role of calcineurin in mineralocorticoid-induced cardiac hypertrophy and fibrosis. METHODS AND RESULTS: Uninephrectomized Wistar-Kyoto rats were placed on a 1.0% NaCl diet and treated with aldosterone (0.75 microg x h(-1)) for 6 weeks with or without the calcineurin inhibitors, FK506 (0.5 mg x kg(-1) x d(-1)) or cyclosporine A (10 mg x kg(-1) x d(-1)). The effect of the angiotensin II type 1 receptor antagonist, losartan (10 mg x kg(-1) x d(-1))on aldosterone-induced cardiac hypertrophy was also studied. Treatment with aldosterone increased the heart weight/body weight ratio, cardiomyocyte size, and collagen amount. The expression of mRNA of both type-III collagen and atrial natriuretic peptide in the heart were increased by aldosterone administration. Both calcineurin activity and its mRNA expression were also increased in aldosterone-induced hypertrophic heart. Treatment with losartan, FK506, or cyclosporine partially prevented aldosterone-induced cardiac hypertrophy and fibrosis. CONCLUSION: These results suggest that calcineurin is involved in the development of cardiac hypertrophy and fibrosis induced by mineralocorticoid excess. Inhibition of calcineurin may therefore prevent cardiac hypertrophy and fibrosis in mineralocorticoid hypertension.

Aldosterone↗

Abnormal coronary vascular response to exercise in dogs with severe right ventricular hypertrophy.

Measurements of right coronary artery blood flow, aortic and right ventricular (RV) pressures and heart rate were radiotelemetered during strenuous, spontaneous exercise in normal dogs and dogs with severe RV hypertrophy induced by chronic (5-6 mo) pulmonary artery stenosis. With fixed pulmonic stenosis, dogs with RV hypertrophy exhibited a decrease (P less than 0.01) in arterial pressure during exercise. Under these conditions, exercise increased right coronary artery blood flow and decreased right coronary vascular resistance less (P less than 0.05) in dogs with RV hypertrophy compared with normal. This attenuated response of right coronary artery blood flow of dogs with RV hypertrophy was not observed when arterial pressures remained at preexercise values during exercise. However, regardless of changes in arterial pressures during exercise, all dogs with RV hypertrophy demonstrated a striking postexercise coronary hyperemia (P less than 0.01), suggesting a perfusion deficit of the hypertrophied right ventricle during exercise. These results imply a fundamental defect in the ability of the coronary circulation of the severely hypertrophied right ventricle to provide sufficient nutrient supply in the face of elevated metabolic demands of exercise.

Animals↗

Regional atrial blood flow in dogs. Effect of hypertrophy on coronary flow reserve.

Little is known regarding regional atrial blood flow responses during varying hemodynamic states in both the normal and hypertrophied atria. This study was undertaken to develop a canine model of chronic atrial hypertrophy and to define in both this group and in normal dogs the regional blood flow response to acute atrial fibrillation and to measure coronary flow reserve. In the 12 dogs with atrial but not ventricular hypertrophy the mean left and right atrial weights were 75 and 47% respectively greater than in the normal group. Blood flow in the normal dogs was less in the appendage than in the non-appendage region for both atria and increased significantly during atrial fibrillation. Similar findings were noted in the hypertrophy group except that during control conditions the left atrial appendage flow was similar to the nonappendage flow. Minimal vascular resistance for the hypertrophy group, 39 +/- 3 was significantly (P less than 0.05) greater when compared to the normal group 28 +/- 2 mmHg/cm3 per min per g. Thus, significant regional blood flow differences occur in both the normal and hypertrophied atria. In addition, atrial hypertrophy does not alter the autoregulatory capacity to the hemodynamic stress of atrial fibrillation but does reduce coronary flow reserve.

Animals↗

Increased rat cardiac angiotensin converting enzyme activity and mRNA expression in pressure overload left ventricular hypertrophy. Effects on coronary resistance, contractility, and relaxation.

We compared the activity and physiologic effects of cardiac angiotensin converting enzyme (ACE) using isovolumic hearts from male Wistar rats with left ventricular hypertrophy due to chronic experimental aortic stenosis and from control rats. In response to the infusion of 3.5 X 10(-8) M angiotensin I in the isolated buffer perfused beating hearts, the intracardiac fractional conversion to angiotensin II was higher in the hypertrophied hearts compared with the controls (17.3 +/- 4.1% vs 6.8 +/- 1.3%, P less than 0.01). ACE activity was also significantly increased in the free wall, septum, and apex of the hypertrophied left ventricle, whereas ACE activity from the nonhypertrophied right ventricle of the aortic stenosis rats was not different from that of the control rats. Northern blot analyses of poly(A)+ purified RNA demonstrated the expression of ACE mRNA, which was increased fourfold in left ventricular tissue obtained from the hearts with left ventricular hypertrophy compared with the controls. In both groups, the intracardiac conversion of angiotensin I to angiotensin II caused a comparable dose-dependent increase in coronary resistance. In the control hearts, angiotensin II activation had no significant effect on systolic or diastolic function; however, it was associated with a dose-dependent depression of left ventricular diastolic relaxation in the hypertrophied hearts. These novel observations suggest that cardiac ACE is induced in hearts with left ventricular hypertrophy, and that the resultant intracardiac activation of angiotensin II may have differential effects on myocardial relaxation in hypertrophied hearts relative to controls.

Angiotensin I↗

Cardiac hypertrophy and histone deacetylase-dependent transcriptional repression mediated by the atypical homeodomain protein Hop.

Activation of multiple pathways is associated with cardiac hypertrophy and heart failure. Repression of antihypertrophic pathways has rarely been demonstrated to cause cardiac hypertrophy in vivo. Hop is an unusual homeodomain protein that is expressed by embryonic and postnatal cardiac myocytes. Unlike other homeodomain proteins, Hop does not bind DNA. Rather, it modulates cardiac growth and proliferation by inhibiting the transcriptional activity of serum response factor (SRF) in cardiomyocytes. Here we show that Hop can inhibit SRF-dependent transcriptional activation by recruiting histone deacetylase (HDAC) activity and can form a complex that includes HDAC2. Transgenic mice that overexpress Hop develop severe cardiac hypertrophy, cardiac fibrosis, and premature death. A mutant form of Hop, which does not recruit HDAC activity, does not induce hypertrophy. Treatment of Hop transgenic mice with trichostatin A, an HDAC inhibitor, prevents hypertrophy. In addition, trichostatin A also attenuates hypertrophy induced by infusion of isoproterenol. Thus, chromatin remodeling and repression of otherwise active transcriptional processes can result in hypertrophy and heart failure, and this process can be blocked with chemical HDAC inhibitors.

Animals↗

Morphometric and biochemical characteristics of ventricular hypertrophy in male rainbow trout (Oncorhynchus mykiss).

We examined the morphometric and biochemical effects of ventricular hypertrophy in male rainbow trout (Oncorhynchus mykiss) during sexual maturation. Our investigation focused on characterizing the growth of ventricular layers, on cardiomyocyte dimensions (length, cross-sectional area and cell volume) and on the activities of enzymes involved in intermediary metabolism. Relative ventricle mass (100 x ventricle mass/body mass) increased by as much as 2.4-fold during sexual maturation [as defined by an increasing gonadosomatic index (100 x gonad mass/body mass)], and this resulted in an increased proportion of epicardium relative to endocardium. Ventricular enlargement was associated with increased length (+31 %) and transverse cross-sectional area (+83 %) of cardiomyocytes, which resulted in an expansion of up to 2.2-fold in mean myocyte volume (from 1233 to 2751 micron3). These results indicate that sexual maturation induces ventricular enlargement through myocyte hypertrophy. Cell length and cross-sectional area were similar in both myocardial layers, and myocytes were elliptical rather than circular in transverse cross section. Ventricular hypertrophy did not alter transverse cell shape, perhaps reflecting the maintenance of short diffusion distances for small molecules as cells hypertrophy. Myocyte hypertrophy could not account entirely for the sevenfold range of ventricle masses from different-sized fish, indicating that myocyte hyperplasia contributes substantially to ventricular growth as trout grow. Measurements of the maximal activities of metabolic enzymes demonstrated that ventricular hypertrophy was associated with (1) higher epicardial but not endocardial activities of citrate synthase (by 23 %) and beta-hydroxyacyl-CoA dehydrogenase (by 20 %); (2) lower activities of hexokinase (by 50 %) in both layers, and (3) no change in lactate dehydrogenase or pyruvate kinase activities, which were also similar between layers. These results suggest that the energetic needs of the hypertrophied trout ventricle may be met through increased reliance on fatty acid oxidation, particularly by the endocardium, but decreased reliance on glucose as a metabolic fuel in both layers.

Animals↗

Quantitative analysis of cardiac hypertrophy due to pressure load in reference to the relations of blood pressure, left ventricular weight and left ventricular capacity.

In almost all of the cases of cardiac hypertrophy due to sustained hypertension, left ventricular capacity is increased in proportion to increased left ventricular weight, even in the absence of manifest cardiac insufficiency. The condition is regarded as the general expression of cardiac response to pressure load, and the concept of "isomorphic hypertrophy" is proposed. Concentric hypertrophy of the current concept is observed only on rare special occasions, and its role in cardiac adaptation to pressure load is obscure. The increase in myocardial mass is sufficient to maintain the work done by a unit myocardial volume at a normal level. However, the calculation on pertinent models demonstrates that hypertrophied hearts of any type expel the normal stroke volume with smaller shortening of muscle fibers under larger stress, which is further elevated with the progress of cardiac contraction. Because the maximum force generated by muscle fibers declines with advancing cardiac contraction, hypertrophied hearts harbor a latent risk of mechanical insufficiency. Even under pressure load, ventricular dilation seems to precede the re-inforcement of ventricular wall in the development of cardiac hypertrophy. A common mechanism may be therefore assumed underlying the development and performance of all types of hypertrophied hearts, regardless of the difference in the character of physical loads.

Adult↗

Association between high grade ventricular arrhythmia and extent of left ventricular hypertrophy in hypertrophic cardiomyopathy.

The association between the extent of left ventricular (LV) hypertrophy and severity of ventricular or atrial arrhythmias are examined. Two-dimensional echocardiography and 24-h Holter electrocardiography monitoring were performed in 60 patients with hypertrophic cardiomyopathy (HCM). According to the distribution of the LV hypertrophy, the patients were divided into three groups: 1. Apical hypertrophy (APH), 2. Septal hypertrophy, and 3. Extensive hypertrophy. Ventricular arrhythmias were found in 82% of the patients and supraventricular arrhythmias were detected in 70% of the patients. Lown grade III and IV arrhythmias occurred significantly more frequently in patients with extensive than with septal hypertrophy. Lown grade III to IV arrhythmias did not occur in patients with APH. Present results show a significant association between the extent of LV hypertrophy and the severity of ventricular arrhythmias in HCM.

Adult↗

Peroxisome proliferator-activated receptors and the control of fatty acid oxidation in cardiac hypertrophy.

Cardiac hypertrophy is a response of the heart to a wide range of extrinsic stimuli, such as arterial hypertension, valvular heart disease, myocardial infarction, and cardiomyopathy. Although this process is initially compensatory for an increase workload, its prolongation frequently results in congestive heart failure, arrhythmia, and sudden death. Cardiac hypertrophy is associated with an increase in glucose utilization and a decrease in fatty acid oxidation. It is unclear at present, however, which consequences might result from impaired oxidation of fatty acids in the heart, but several studies have demonstrated that substrate utilization is important in the pathogenesis of cardiac hypertrophy. Here we will focus on the effects of cardiac hypertrophy on the activity of Peroxisome proliferator-activated receptors (PPARs), ligand-activated transcription factors that regulate the expression of genes involved in fatty acid uptake and oxidation, lipid metabolism and inflammation. Interestingly, activation of the Nuclear Factor (NF)-kappaB signaling pathway, which is one of the most important signal transduction pathways involved in the hypertrophic growth of the myocardium, may suppress the activity of the PPARs, affording a link between cardiac hypertrophy and the fall in fatty acid oxidation in the hypertrophied heart. As a result, inhibition of NF-kappaB activation during cardiac hypertrophy may also ameliorate cardiac fatty acid oxidation, achieving a better improvement in the prevention or inhibition of this pathological process.

Animals↗

Converting enzyme inhibition specifically prevents the development and induces regression of cardiac hypertrophy in rats.

Antihypertensive agents have been shown to differ markedly in their effects on the development and regression of cardiac hypertrophy. In view of possible trophic properties of angiotensin II (ANG II), we compared the effects of equipotent antihypertensive doses of the converting enzyme (CE) inhibitor ramipril (1 mg/kg), the calcium antagonist nifedipine (30 mg/kg), and the arterial vasodilator dihydralazine (30 mg/kg) on cardiac mass in rats subjected to banding of the abdominal aorta. Treatment was started either immediately after banding ("prevention experiments") or after hypertension and hypertrophy had already developed ("regression experiments"). Groups of untreated animals with aortic constriction and sham-operated animals served as controls. In the prevention experiments heart weight, myocardial protein content and ANG II plasma levels were significantly increased in untreated animals and in those receiving nifedipine and dihydralazine. In contrast, values obtained in animals treated with ramipril were not different from those seen in normotensive, sham operated controls with the exception of plasma ANG II levels which were lower. Similar results were observed in the second series of studies which examined the effect of antihypertensive agents on the "regression" of cardiac hypertrophy. Treatment was started 6 weeks after aortic banding and continued for another 6 weeks. While all three drugs lowered blood pressure equally well, only ramipril induced a significant and complete regression of cardiac hypertrophy to values not different from sham-operated controls. In addition we studied a group of animals treated with a nonantihypertensive low dose of ramipril (10 micrograms/kg). Remarkably, these animals showed the same complete regression of cardiac hypertrophy as seen in the group receiving the antihypertensive dose of CE inhibitor. Our study indicates a selective advantage of CE inhibitors over other antihypertensive drugs in the prevention and regression of hypertensive cardiac hypertrophy. Importantly, the dissociation between effects on blood pressure and cardiac mass demonstrated in the experiments with a low dose of ramipril stresses the role of factors other than blood pressure and afterload on the development of hypertensive cardiac hypertrophy. One such peptide, thus, may be ANG with its known potential as a growth factor.

Angiotensin II↗

Echocardiographic left ventricular hypertrophy: clinical characteristics. The Framingham Heart Study.

Recent data suggest that echocardiographic left ventricular (LV) hypertrophy is associated with increased cardiovascular morbidity and mortality. Based upon application of sex-specific echocardiographic criteria for LV hypertrophy, the clinical characteristics of 863 subjects with and 4097 subjects without LV hypertrophy are examined. Subjects with LV hypertrophy are older, more obese, have higher blood pressure, and are more likely to have pre-existing coronary artery disease. In addition subjects with LV hypertrophy have a higher prevalence of reduced echocardiographic fractional shortening. We conclude that subjects with echocardiographic LV hypertrophy are at high risk for cardiovascular disease complications by virtue of their clinical profile. Additional investigation of the benefits of therapeutic interventions directed toward the prevention or regression of LV hypertrophy is warranted.

Adolescent↗

The role of guanine nucleotide binding proteins in hamsters with myocardial hypertrophy.

To clarify the role of the guanine nucleotide binding proteins (G-proteins) in the pathogenesis of myocardial hypertrophy, we investigated the alterations in myocardial G proteins in 20-week-old F1b hamsters with pressure overload induced for 3 days (3-day AS), 7 days (7-day AS) and 14 days (14-day AS) by the stenosis of the abdominal aorta, and in 4- and 20 week-old BIO 14.6 Syrian hamsters (4-wk and 20-wk BIO) with genetic myocardial hypertrophy. The hearts of 7-day AS, 14-day AS and 20-wk BIO with left ventricular hypertrophy exhibited a decrease in the mRNA levels detected by Northern blot analysis and protein levels of G protein detected by Western blot analysis as compared with sham-operated and age-matched F1b hearts. The function of Gs or Gi showed a concomitant reduction in both models of myocardial hypertrophy. The hearts of 3-day AS and 4-wk BIO without myocardial hypertrophy showed no changes in G proteins as compared with sham-operated and age-matched F1b hearts. These results suggest that a decrease in G proteins is not involved in the pathogenesis of myocardial hypertrophy, but that myocardial hypertrophy reduced the G proteins.

Adenylyl Cyclases↗

Effects of moderate pressure overload cardiac hypertrophy on the distribution of creatine kinase isozymes.

Myocardial activities and isozyme distributions of creatine kinase (CK) and lactate dehydrogenase (LDH) were measured in rats with moderate pressure overload hypertrophy. Three weeks after aortic banding, the ratio of left ventricular (LV) weight to body weight increased by 30%. Values for enzyme activity in the hypertrophied LV were compared to values for control rats as well as to the contralateral relatively unaffected right ventricle (RV). In rats with moderate LV hypertrophy, total CK activity was unchanged. The percent MB-CK increased significantly (p less than 0.01) only in the hypertrophied LV, from 13 +/- 1% to 19 +/- 1% of total CK, while the sum of MM and mitochondrial-CK decreased from 86 +/- 3 to 80 +/- 3% (p less than 0.01). LDH activity increased (p less than 0.05) only in the hypertrophied ventricle from a control of 2.90 +/- 0.13 to 3.21 +/- 0.13 IU/mg protein, while the ratio of LDH activity at high to low substrate increased from 0.12 +/- 0.02 to 0.14 +/- 0.02 (p less than 0.05). Thus, the development of moderate pressure overload hypertrophy in the LV is associated with normal levels of total CK, but the percentage of MB-CK increases selectively in the primarily affected ventricle. Also, total LDH and LDH activity at high to low substrate concentration increases significantly in LV hypertrophy.

Animals↗

[Quantitative analyses of alpha-adrenoceptors in human prostatic capsule, adenoma and urethra--a comparison between normal prostate and hypertrophied prostate].

The adrenergic alpha-1 and -2 receptors in the three layers of the prostate (capsule, adenoma and urethra) were measured in humans with or without benign prostatic hypertrophy to examine the differences between the hypertrophied and non-hypertrophied (normal) prostate. Both alpha-1 and -2 receptors were found to exist in similar amounts in prostatic adenoma of both hypertrophied and normal prostate groups. In the prostatic capsule and urethra of both groups alpha-1 receptors were more abundant than alpha-2 receptors. Both alpha-1 and -2 receptors in all three prostatic layers were found to be increased significantly in hypertrophied group compared to normal group. Further more the increases in alpha-1 and -2 receptors of hypertrophied group were most remarkable in prostatic adenoma. These results seems to demonstrate that not only alpha-1 but also alpha-2 receptors play some important roles in benign prostatic hypertrophy.

Adenoma↗

Nonsustained Ventricular Tachycardia as a Predictor of Cardiovascular Events in Black Men With Hypertensive Left Ventricular Hypertrophy.

OBJECTIVE: To determine the prognostic significance of asymptomatic nonsustained ventricular tachycardia in Black males with hypertensive left ventricular hypertrophy without apparent coronary artery disease. BACKGROUND: The Framingham study has demonstrated a higher incidence of cardiovascular mortality including sudden cardiac death in patients with hypertensive left ventricular hypertrophy. Several studies have demonstrated an increased incidence of complex ventricular arrhythmias in patients with left ventricular hypertrophy even in the absence of significant coronary artery disease. There are few long term data, however, regarding the cardiovascular morbidity and mortality associated with asymptomatic ventricular arrhythmias in Black males with essential hypertension and left ventricular hypertrophy. METHODS: Baseline 48 hour Holter monitoring was performed in 110 Black males with hypertensive left ventricular hypertrophy and the presence of nonsustained ventricular tachycardia; the occurrence and frequency of ventricular ectopy were recorded. The study end point was all cause mortality and cardiovascular morbidity (cerebrovascular accident, congestive heart failure, myocardial infarction, and new onset angina). RESULTS: In the 22 patients with nonsustained ventricular tachycardia there were a total of nine events compared to eight events in the 78 patients without nonsustained ventricular tachycardia. During a mean follow up period of 6.4Â+/-2.1 years, patients with hypertensive left ventricular hypertrophy and nonsustained ventricular tachycardia on baseline Holter electrocardiogram had an event rate of 41% compared with only 10% in patients without nonsustained ventricular tachycardia (p is less than 0.0001). Using a multivariate Cox proportional hazards model to adjust for age and left ventricular mass index the presence of nonsustained ventricular tachycardia was strongly and independently associated with increased all cause mortality and cardiovascular morbidity (relative risk 12.7, confidence interval 4.1-38.7; p is less than 0.0001). CONCLUSIONS: The presence of nonsustained ventricular tachycardia in hypertensive Black males with left ventricular hypertrophy is a strong and independent predictor of cardiovascular events. (c)2000 by Le Jacq Communications, Inc.

Journal Article↗

Apical hypertrophic cardiomyopathy (apical hypertrophy): an overview.

Clinical and laboratory data of apical hypertrophy were reviewed based on our experience of over 200 consecutive patients, of whom 126 patients were followed up by myself for more than 1 year (1 to 29 years). Emphasis was placed on various aspects of electrocardiography including the natural course and "wax and wane" phenomenon of giant negative T waves (GNT). Recent diagnostic modality, i.e., cardiac magnetic resonance imaging was also stressed. Apical hypertrophic cardiomyopathy (apical hypertrophy) was mainly discovered by annual health check including electrocardiography and characterized by giant negative T waves (GNT; -1.0-(-)4.2 mV) in the left precordial leads (V4 or V5) in middle-aged men. Transition from normal T wave to negative T wave required several years and remained usually unchanged thereafter. This change may occur rather abruptly on rare occasions. Disappearance of GNT may also occur slowly and progressively in patients, in whom apical aneurysm had developed. The diagnosis may be obtained with echocardiography, left ventriculography or ultrafast computed tomography, but was most accurate with cardiac magnetic resonance imaging, by which identification of the diversity of hypertrophy was achieved, because the multiple short-axis views were accurately obtained in addition to the exact long-axis view. Hypertrophy was not simple but quite complex in both morphology and grade. Gene abnormality may be present even in cases of apical hypertrophy. The prognosis of apical hypertrophy in Japan has been benign, and heart failure due to atrial fibrillation and left ventricular aneurysm due to the destruction of hypertrophied muscle are thought to have prognostic importance, but these were rare in our series.

Adult↗

[Apoptosis in pressure overload-induced heart hypertrophy].

Pressure overload can result in heart hypertrophy, and induce apoptosis, but the phenomenon of apoptosis during the forepart of cardiomyocyte hypertrophy remains unclear. The aim of this study was to inquire into the process of cardiomyocyte apoptosis during the forepart of cardiomyocyte hypertrophy. We constructed the hypertrophy model by transverse aortic constriction of male SD rat. The apoptosis ratio was detected by TUNEL method and FCM. The result demonstrated that hypertrophy indexes increased with the time of constriction, reached the highest level at day 7, maintained that level, and then decreased at day 91. The apoptosis ratio of cardiomyocyte at day 4 was higher than that at day 0 detected by FCM method, and the ratio at day 7 was markedly lower than that at day 4. After day 28, the apoptosis ratio of cardiomyocyte went up again with the time of constriction after surgery. TUNEL method revealed that positive nuclei were observed in cardiomyocytes exclusively in the left ventricle; the apoptosis ratio increased when constriction continued. TUNEL method confirmed the result of FCM. These data indicate that cardiac hypertrophy is initiated by apoptosis of cardiomyocyte, these two factors(hypertrophy and apoptosis) maintain the balance between growth and death during the early short period of aortic constriction, and when aortic constriction goes on they are involved in the pathogenesis of heart remodeling.

Adaptation, Physiological↗