Biomechanical signals regulating the structure of the heart

Cardiac remodeling is regulated at the cellular level by coordinated responses to biomechanical signals, such as actomyosin contractile forces, hemodynamic loading, and extracellular matrix (ECM) mechanical properties. In cardiac muscle cells (cardiomyocytes), the nucleus and the ECM are physically connected by a series of structural protein networks that span the cell membrane, the sarcomere, the cytoskeleton, and the nucleoskeleton. Consequently, prolonged abnormal forces (e.g. hypertension, fibrosis, protein variants) are 'sensed' by and propagated through these biological structures, ultimately inducing gene expression programs that mediate remodeling of cell and tissue structure. In this brief review, we discuss mechanisms by which biomechanical stimuli are transmitted and transduced into cellular responses that regulate cardiac phenotypes, focusing on cardiomyocyte remodeling in disease settings.