LAUSR

Increased left ventricular wall stress precedes the development of heart failure in multiple myocardial pathologies. Increased wall stress can occur in many forms. It may occur globally from increased in pressure throughout the ventricle such as in hypertension or aortic stenosis or regional as in myocardial ischemia where scar or dysfunctional myocardium creates imbalances in stress between areas of normal and hypo-perfusion. At a cellular level, loss of myocytes throughout the myocardium due to toxins or myocarditis leads to replacement fibrosis altering the strain properties of the tissue and increasing wall stress. Similarly, genetic alterations in sarcomeric structure can predictably change stress locally resulting in compensatory hypertrophy or dilation.