Life and death of a cardiac myocyte: principles of cellular biology

If the future of extracorporeal circulation is to include approaches to enhance localized or widespread distribution of cells, and/or gene transfer for augmentation of cardiac function, it is imperative that we gain an increased understanding of the mechanisms that define the cardiac myocyte phenotype. The purpose of this paper is to review the natural history of the cardiac myocyte. A variety of signals determine the cellular processes that characterize birth, growth, differentiation and death of cardiomyocytes. Examined here are primary aspects of the molecular genetics of growth and development, including signal transduction, protein phosphorylation, the cell division cycle, and transcriptional activation. This review is intended to be an update on insights into molecular aspects of the cell. with emphasis on gene expression during cardiac myogenesis and a discussion of its relevance to the field of extracorporeal circulation. In addition, the current status of research in myogenesis is presented.