Apoptosis and heart failure: clinical relevance and therapeutic target

Heart failure is the final common pathway of diverse ethiologies that are characterized by impaired systolic and/or diastolic function with high morbidity and mortality. An integral part of pathogenesis of heart failure is myocyte loss. The traditionnal explanation for myocyte loss was cell necrosis but over the last decade, there has been a surge of evidence affirming the role of apoptosis in genesis of heart failure. Studies have raised apoptosis from a 'histologic curiosity' to an exciting 'clinical target' that can be modulated to attenuate the progressiom of heart failure. This review will focus on the clinical relevance of apoptosis in human and experimental heart failure and identify some of the progress made in myocardial anti-apoptotic intervention.