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2006 ; 10
(1
): 56-75
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Morphological aspects of apoptosis in heart diseases
#MMPMID16563222
Takemura G
; Fujiwara H
J Cell Mol Med
2006[Jan]; 10
(1
): 56-75
PMID16563222
show ga
It has been suggested that apoptosis may be responsible for a significant amount
of cardiomyocyte death during acute myocardial infarction as well as for a
progressive loss of surviving cells in failing hearts. Typical apoptosis can
indeed be induced in cardiomyocytes at the experimental conditions. In actual
heart diseases, in contrast, there is very little direct morphological evidence
of apoptosis in cardiomyocytes occurring at any stage of myocardial infarction
and heart failure, despite the availability of much indirect evidence that
includes detection of DNA fragmentation and apoptosis-related factors. For that
reason, the potential efficacy of therapeutic intervention to prevent apoptosis
remains controversial. This review will survey available data from both animals
and humans to critically assess the role of cardiomyocyte apoptosis during
myocardial infarction and its relevance to myocardial remodeling and during
progression to heart failure. Also considered will be nonmyocyte interstitial
cells, which have received less attention than myocytes despite definitive
evidence of their apoptosis in the infarcted heart and recent studies suggesting
that blockade of apoptosis among these cells mitigates postinfarction cardiac
remodeling and heart failure. We conclude from our survey that there are many
hurdles to surmount before regulation of apoptosis can be clinically applied in
the treatment of myocardial infarction and heart failure.