Programmed necrosis, not apoptosis, in the heart

Gloria Kung, Klitos Konstantinidis, Richard N. Kitsis

Research output: Contribution to journalReview articlepeer-review

187 Scopus citations


It is well known that apoptosis is an actively mediated cell suicide process. In contrast, necrosis, a morphologically distinct form of cell death, has traditionally been regarded as passive and unregulated. Over the past decade, however, experiments in Caenorhabditis elegans and mammalian cells have revealed that a significant proportion of necrotic death is, in fact, actively mediated by the doomed cell. Although a comprehensive understanding of necrosis is still lacking, some key molecular events have come into focus. Cardiac myocyte apoptosis and necrosis are prominent features of the major cardiac syndromes. Accordingly, the recognition of necrosis as a regulated process mandates a reexamination of cell death in the heart. This review discusses pathways that mediate programmed necrosis, how they intersect with apoptotic pathways, roles of necrosis in heart disease, and new therapeutic opportunities that the regulated nature of necrosis presents.

Original languageEnglish (US)
Pages (from-to)1017-1036
Number of pages20
JournalCirculation research
Issue number8
StatePublished - Apr 15 2011


  • apoptosis
  • cell death
  • heart failure
  • myocardial infarction
  • necrosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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