Circulation, Vol 90, 556-573, Copyright © 1994 by American Heart Association
TN James
Apoptosis and necrosis are two distinctly different forms of cell death,
and both occur in the human heart. In contrast to necrosis, apoptosis is
not associated with inflammation for two reasons. First, the apoptotic cell
does not swell or rupture before it is engulfed by either a macrophage or
even a neighboring like cell. Second, the phagocytosis occurs with unusual
rapidity. Apoptosis, also thought of as cell suicide, is a tidy way of
removing cells no longer useful, in essence a form of selective deletion.
These features make apoptosis a valuable component of morphogenesis,
mediation of hormonal and immunologic responses, and the homeostatic
balance between hypertrophy and atrophy or involution. In the human heart
apoptosis has been found in the sinus node of patients with the long QT
syndrome. It most likely participates in the important postnatal
morphogenesis of the sinus node, AV node, and His bundle. Apoptosis may
also participate in the genesis and pathophysiology of cardiomyopathy,
paroxysmal arrhythmias, or conduction disturbances (some of which may be
responsible for sudden death), focal fibromuscular dysplasia of small
coronary arteries, hereditary medial degeneration of the tunica media of
coronary arteries, and arrhythmogenic right ventricular dysplasia. The
possible role apoptosis in numerous other changes in the human heart, among
them the pathogenesis of atherosclerosis and mechanisms of aging in the
myocardium, merits future investigation.
ARTICLES
Normal and abnormal consequences of apoptosis in the human heart. From postnatal morphogenesis to paroxysmal arrhythmias
Department of Medicine, University of Texas Medical Branch, Galveston 77555-0129.
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P. Hamet Cancer and Hypertension: An Unresolved Issue Hypertension, September 1, 1996; 28(3): 321 - 324. [Full Text]
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T. N. James, M. M. Nichols, D. W. Sapire, P. L. DiPatre, and S. M. Lopez Complete Heart Block and Fatal Right Ventricular Failure in an Infant Circulation, April 15, 1996; 93(8): 1588 - 1600. [Full Text]
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T. N. James, E. St. Martin, P. W. Willis III, and T. O. Lohr Apoptosis as a Possible Cause of Gradual Development of Complete Heart Block and Fatal Arrhythmias Associated With Absence of the AV Node, Sinus Node, and Internodal Pathways Circulation, April 1, 1996; 93(7): 1424 - 1438. [Abstract] [Full Text]
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