Cardiac hypertrophy: its characteristics as a growth process.

The causal relation between cardiac function and growth is analyzed in this review article. Three different levels of development are discussed: cytodifferentiation, embryogenesis and postnatal development. The earliest stage of cardiac morphogenesis, that is, the appearance of cell-specific proteins and of spontaneous contractions, appears to be independent of hemodynamic forces. Also, the first major morphologic transformation of the primitive heart, looping, is the intrinsic property of the heart itself. However, at any later stage of life, hemodynamic function in both health and disease is closely coupled to cardiac growth.