DEATH BY APOPTOSIS OF CARDIOMYOCYTES - FR OM THE CELL TO THE CLINICAL-FEATURES

Cell hypertrophy, modulations of gene expression or changes of the act ivity of proteins are known to play a role in remodelling of diseased myocardium. However, few data are available concerning regulation of t he cell mass in heart disease. While cardiomyocyte hyperplasia remains controversial and probably constitutes a negligible phenomenon, the d ecreased number of cells could argely contribute to alterations of the pathological myocardium. This loss of myocytes was mainly attributed to process of cell necrosis until it was demonstrated that cardiac myo cytes can also die via apoptosis. This has been observed in ischaemic [1], hypertrophic [2], and dilated [3, 4] cardiomyopathy and in arrhyt hmogenic right Ventricular dysplasia [5], to mention only the main dis eases, and this list continues to grow [6]. Apoptosis therefore consti tutes a major biological phenomenon in cardiology, at least at congres ses and in scientific publications, but its place and significance in the pathophysiology of heart disease has yet to be established.