NECROSIS AND APOPTOSIS IN CARDIAC TISSUE: HISTOLOGICAL MANIFESTATIONS AND ANALYSIS
Abstract
Two main forms of cell death in heart tissue — necrosis and apoptosis — play an important role in the development of heart diseases and the occurrence of severe complications. This article is devoted to an in-depth analysis of the histological manifestations of necrotic and apoptotic processes in heart muscle tissue, their role in pathogenesis and clinical significance. The article extensively discusses the microscopic signs of these processes, methods of analysis based on histochemical markers, and cellular changes detected using electron microscopy. It also covers the differences between necrosis and apoptosis, how they manifest themselves in heart tissue, and their role in clinical conditions such as heart attacks and heart failure. This study allows for an in-depth analysis of cell death processes in heart tissue not only at the histological but also at the molecular level. During the study, methods such as the TUNEL method, Caspase-3 markers, H\&E stains, Masson trichrome stain were used, and based on the results, morphological and molecular criteria for necrosis and apoptosis were determined. The article is enriched with modern scientific literature and international studies and serves as a useful resource for medical students, histologists, pathomorphologists, and cardiologists. In particular, in-depth study of these processes is an urgent issue in order to increase the regenerative potential of cardiac tissue and improve cardioprotective therapies.
References
1. Kumar, V., Abbas, A. K., & Aster, J. C. (2020). *Robbins and Cotran Pathologic Basis of Disease* (10th ed.). Elsevier. – Morphological basis of cell death processes in cardiac tissues.
2. Buja, L. M., & Vander Heide, R. S. (2016). Apoptosis and necrosis: basic types and roles in cardiovascular disease. *Cardiovascular Pathology*, 25(5), 333-339. – Pathophysiology of apoptosis and necrosis in the heart.
3. Frangogiannis, N. G. (2019). The extracellular matrix in myocardial injury, repair, and remodeling. *Journal of Clinical Investigation*, 129(7), 2333–2345. – Necrosis and tissue regeneration in the infarct area.
4. Whelan, R. S., Kaplinsky, V., & Kitsis, R. N. (2010). Cell death in the pathogenesis of heart disease: mechanisms and significance. *Annual Review of Physiology*, 72, 19-44. - Importance of apoptosis and necrosis mechanisms in heart diseases.
5. Elmore, S. (2007). Apoptosis: a review of programmed cell death. *Toxicologic Pathology*, 35(4), 495–516. - Apoptosis mechanisms and molecular markers.
6. Tannous, P., Zhu, H., Johnstone, J. L., Shelton, J. M., Rajasekaran, N. S., Benjamin, I. J., & Hill, J. A. (2008). Autophagy is an adaptive response in desmin-related cardiomyopathy. *Proceedings of the National Academy of Sciences*, 105(28), 9745–9750. – Apoptosis and other forms of cell death.
7. Otsuka, F., Yahagi, K., Sakakura, K., & Virmani, R. (2014). Why is the mammalian heart unable to regenerate? *Cardiovascular Research*, 103(2), 194–204. – Apoptosis and the potential for heart tissue regeneration.
8. Galluzzi, L., Vitale, I., Abrams, J. M., et al. (2018). Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018. *Cell Death and Differentiation*, 25, 486–541. – Classification of apoptosis and necrosis types.
9. Dimmeler, S., & Zeiher, A. M. (2000). Endothelial cell apoptosis in angiogenesis and vessel regression. *Circulation Research*, 87(6), 434–439. - The role of apoptosis in the vascular system.
10. Karch, J., & Molkentin, J. D. (2015). Regulated necrotic cell death: the passive demise of cells that might actually matter. *The American Journal of Pathology*, 185(7), 1800–1816. - Regulated forms of necrosis.
11. Reed, J.C. (2000). Mechanisms of apoptosis. *The American Journal of Pathology*, 157(5), 1415–1430. - Molecular markers and apoptosis pathways.
12. Takemura, G., & Fujiwara, H. (2006). Role of apoptosis in myocardial infarction. *Circulation Journal*, 70(3), 135–139. – Dynamics of apoptosis and necrosis in myocardial infarction.
13. Zhan, L., Li, J., Wang, H., et al. (2020). Machine learning-based histopathological image analysis for heart tissue. *Nature Communications*, 11(1), 1–11. – Histological analysis using artificial intelligence.
14. Laitinen, M., Peuhkurinen, K., & Vauhkonen, T. (2022). New therapeutic strategies for cardiomyocyte apoptosis prevention. *Trends in Cardiovascular Medicine*, 32(4), 235–243. – Anti-apoptosis therapies.
15. National Heart, Lung, and Blood Institute (NHLBI). (2023). Heart disease statistics. – World statistics and epidemiology of heart disease.
