THE MOLECULAR AND CELLULAR BIOLOGY OF HEART-FAILURE

We review recent publications involving molecular biology and heart fa ilure. There was some further evolution in our knowledge of the basis for the simplest of molecular genetic diseases-single gene disorders. This year, hypertrophic cardiomyopathy had further genes identified as causative mutations; was shown to have the same genetic defects in sp ontaneous and familial cases; and demonstrated phenotypic alteration b y environmental factors. Several rare cardiomyopathies were linked to the dystrophin gene, previously identified as the mutated gene respons ible for forms of muscular dystrophy. Molecular methods were applied t o linking viral infection to dilated cardiomyopathy by hunting for vir al genomes in heart muscle, and for seeking mutations in mitochondrial DNA. Molecular treatment of restenosis after angioplasty showed promi se through the application of gene transfer to vascular tissue by olig onucleotides as well as adenovirus-mediated gene transfer. The ethical aspects of diagnosing and treating human disease using genetic inform ation, which receive frequent discussion in print, are also reviewed.