Maqbool H Jafary.
Apoptosis and Cardiovascular disease: Focus on Heart Failure.
Pak J Med Sci Jan ;17(4):193-6.

Strictly defined, apoptosis means programmed cell death. It is a natural, orderly, energy-dependent process that causes the cells to die without inducing an inflammatory response. It involves discrete genetic and molecular programs. It needs to be differentiated from necrosis which also implies cell death. However, necrosis which can be called unregulated cell death results from acute deprivation of the tissues from their blood supply eg., myocardial infarction or stroke. At times, however, the differentiation between the two may not be clear cut and both the processes may seem to coexist. Apoptosis is generally a slow process which occurs physiologically as well as pathologically. One fine example of physiological or non-pathological apoptosis is that of formation of heart in the embryo. During organogenesis of the heart, cell death is common and widespread, under tight control and it is rarely necrotic. At many sites of the embryo, apoptosis as a process, is used to eliminate vestigial organs and it is a source of remodeling of the heart to its functional status in the newborn. Formation of heart chambers occurs with heavy participation of apoptosis1. Same is the case with interconnection between ventricles and the major blood vessels2. In physiological terms therefore, apoptosis is a process of programmed cell death, eliminating the undesirable cells and tissues to give a proper shape and functional qualities, when the organ gets fully formed to a mature state. This not only applies to the heart but also to all the organs in development of embryo to the foetus.

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