Cardiomyocytes die by apoptosis in addition to necrosis under a variety of pathological conditions including heart failure, cardiomyopathy, and ischemia/reperfusion. This review summarizes current status of the literature demonstrating evidence of apoptotic cell death in heart failure and ischemic heart disease. Apoptotic cells have been detected in failing hearts of human and dog. Ischemia up to 2 hr does not induce apoptosis, but reperefusion of ischemic heart can trigger apoptosis and DNA fragmentation. Apoptosis appears to occur in a varity of animal species including mouse, rat, rabbit, swine, dog and human suggesting that this is not species-specific.
Striking similarities exist between the mechanisms of reperfusion injury and apoptosis: both involve free radicals, Ca2+ and phospholipids. Evidence exists in the literature to indicate role of oxygen free radicals and phospholipids in apoptotic cell death induced by ischemia and reperfusion. Apoptotic cell death in rat heart was inhibited by free radical scavengers or antioxidants.