ESC Calls for Clarification of Heart Terminology

Cardiac hypertrophy needs to be redefined

(RxWiki News) To many of us complicated medical terminology sounds similar. But in fact many of these terms may lack enough precision or have too much generality, prompting the European Society of Cardiology to call for redefinition.

The ESC Working Group on Myocardial Function is calling for a redefinition of the term cardiac hypertrophy for better precision. Cardiac hypertrophy is currently used to describe changes to the structure of the heart.

A position paper published recently by ESC suggests the more general term myocardial remodeling is preferred.

"The new definition would increase accuracy."

Jean-Luc Balligand, from the Université Catholique de Louvain in Belgium, previous chair of the myocardial function working group, said she hoped such a redefinition would help increase communication between researchers and spur additional research in cardiac remodeling.

In cell biology the term hypertrophy describes growth through cell enlargement as opposed to growth by cell division, where hyperplasia is the correct term. In cardiology the term hypertrophy is commonly applied to the situation in the whole heart where myocardial enlargement is accompanied by both hypertrophy and hyperplasia.

The term hypertrophy also does not consider that non-myocytes, or heart muscle cells,  in the heart are not passive bystanders and change in number when the heart remodels. There also may be an invasion of inflammatory cells into the heart, and the growth of new blood cells may occur.

The working group has proposed that the term hypertrophy should be restricted to cardiac myocytes rather than the entirety of the heart.

In the paper the authors also challenged an accepted thought that any form of cardiac remodeling is ultimately bad. The group wrote that there are differences between maladaptive remodelling that leads to heart failure, and adaptive remodelling that does not result in heart failure.

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Review Date: 
June 27, 2011