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(Circulation. 2008;117:338-340.)
© 2008 American Heart Association, Inc.

Editorial

Nix: The Cardiac Styx Between Life and Death

Paula A. da Costa Martins, PhD; Leon J. De Windt, PhD

From the Hubrecht Institute and Interuniversity Cardiology Institute Netherlands, Royal Netherlands Academy of Sciences (P.A.d.C.M., L.J.D.W.); and Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht (L.J.D.W.), Utrecht, the Netherlands.

Correspondence to Dr Leon J. De Windt, Department of Medical Physiology, Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands. E-mail dewindt@niob.knaw.nl

Key Words: Editorials • apoptosis • heart failure

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 

Now let Earth be my witness and the broad heaven above, and the down flowing water of the Styx...

— —Homer, Iliad XV. 36–37: Greek Oath-Rituals.

In Greek mythology, the river Styx is a river that formed the boundary between earth and the underworld or Hades, the abode of the dead. The ferryman of the river Styx was called Charon, a personification of the decision-making process between life and death. According to some versions of the myth, the river Styx had miraculous powers and could make someone immortal. Achilles was said to have been dipped in it as a child, thereby becoming invulnerable, with the exception of his heel, which was held by his mother to submerge him in the flowing waters of the Styx. His exposed heel gave rise to the expression "Achilles’ heel," a metaphor for a weak spot in modern meaning, as Achilles was killed in the battle for Troy by an arrow to the heel.

Article p 396

The boundary between life and death continues to intrigue humanity today as much as it did 3 millennia ago, and in our current era, with a clear need for a detailed understanding of the genetic circuits driving the onset of human disease, death pathways are becoming increasingly relevant for understanding acquired heart failure. The failure of cell-survival pathways to inhibit myocyte apoptosis seems a critical step in the initiation of heart failure that results in apoptotic cardiomyocyte dropout with replacement fibrosis. Unlike necrosis (oncosis), apoptosis is an orderly . . . [Full Text of this Article]