Mechanisms of cell death in heart failure

A progressive, often self-perpetuating process of myocardial remodeling is an important determinant of HF (heart failure) and myocardial cell loss by any mechanism is an important component in the genesis of remodeling. Although necrosis has been regarded as the predominant mode of myocardial cell death, there is increasing evidence that cells die through a variety of programmed and nonprogrammed mechanisms of cell death. In addition to necrosis, cardiac cells may be lost through apoptosis, and also autophagy associated with ubiquitinated protein accumulation (Fig. 1) [1-3]. Apart from mechanistic insights, understanding of mechanisms of cell survival and death may offer novel therapeutic approaches.