Apoptosis in Cardiovascular Pathogenesis

The loss of cardiomyocytes in the human myocardium results in overloading of the heart, causing structural remodeling of the heart and deterioration of the cardiac function, eventually leading to heart failure. Cellular suicide or apoptosis of cardiac muscle cells has been identified as an essential process in the progression to heart failure. This process entails a highly structured series of events that gradually shuts down cellular functions, leading to removal of the cardiac muscle cell, with minimal consequences to the surrounding tissue. Because of the impact of apoptosis on cardiac function, cardiomyocyte resuscitation by preventing programmed cell death holds a highly interesting potential as a therapeutic target. For future rational drug design aimed at limiting cardiac cellular loss, it is necessary to have a full understanding of the apoptotic pathways that are functional in the cardiac muscle. This chapter summarizes the apoptotic pathways operative in cardiac muscle and discusses therapeutic options related to apoptosis for the future treatment of human heart failure.