Alterations in both death and survival signals for apoptosis in heart failure due to volume overload

Heart failure is known to be associated with an increase in cardiomyocyte apoptosis; however, neither its occurrence nor the mechanisms involved in hearts failing due to volume overload are completely understood. This study examined some of the signal pathways, which are known to regulate pro- or anti-apoptotic proteins, in heart failure due to volume overload induced by arteriovenous (AV) shunt in male Sprague–Dawley rats. Animals were assessed for cardiac function at 16 weeks of the operation and the left ventricle was used for studying apoptosis and associated signal transduction mechanisms. Hemodynamic and echocardiographic data indicated the presence of severe heart failure in AV shunt rats. A marked elevation in the amount of tumor necrosis factor-α and increased occurrence of apoptosis were detected in the volume overloaded myocardium. Western blot analysis revealed a significant increase in BAX and caspases 3/9 proteins in the failing hearts whereas the levels of phosphorylated Akt and Bcl-2 proteins were decreased. These data suggest that there is a downregulation in the Akt-dependent survival signal involving anti-apoptotic protein, Bcl-2, whereas the signals for the pro-apoptotic protein, BAX, are upregulated and these alterations may play a role in cardiomyocyte apoptosis in heart failure due to volume overload.