ABSTRACT
Cardiac myocyte death occurs by apoptosis, necrosis, and perhaps autophagy. These death forms exhibit distinct morphologies, but appear to be regulated by partially overlapping molecular circuits. Apoptosis, the best understood form of cell death, is mediated by two central pathways, one involving cell surface receptors and the other cytoplasmic organelles including mitochondria and the endoplasmic reticulum. The mechanisms of necrosis are less well defined, although recent work in lower organisms suggests that this process may not be as ‘accidental’ as previously believed. Each of these types of cell death occurs in the heart under stressful conditions and during disease. In experimental models, cell death has been causally linked to the pathogenesis of myocardial infarction and heart failure. These data suggest that the regulated nature of certain forms of cardiac myocyte death may be exploited to provide novel therapies for these most common cardiac syndromes. This chapter reviews recent advances in the understanding of cell death mechanisms and how they relate to heart disease.
