Cardiac damage in athlete’s heart: When the “supernormal” heart fails!

Table 1 Differences in between physiological and pathological hypertrophy

Physiological hypertrophy	Pathological hypertrophy
Angiogenesis, release of VEGF	Perivascular fibrosis and inflammation
Activation of IGF-1 pathway (IGF-1- > PI3K- > Akt)	Activation of Angiotensin II, Catecholamine and Endotelin-1
No fibrosis	MAPK and Calcineurin pathway
Normal gene expression	Fibrosis, myocyte necrosis and apoptosis
Proportional chamber enlargement	Cardiac dysfunction

The table summarizes the differences in the cellular and molecular pattern between physiological and pathological hypertrophy. VEGF: Vascular endothelial growth factor; IGF-1: Insulin like growth factor; PI3K: Phosphoinositide 3-kinase; MAPK: Mitogen-activated protein kinase.