Contents


Preface

The study of the structure and behavior of cardiomyocyte is fundamental to the education of all cardiologists because it is the bridge leading from basic science to clinical cardiology. The marked diversity of cells constituting the tissues and organs of the human body is known. There are more than 200 morphologically distinct adult cell types and this large number reflects the diversity of their function. However, despite this diversity of structure and function, there is a small range of structural subunits and organelles that comprise these cell types. A cell with a particular function will have a predictable constellation of organelles relating to that specialization. So, understanding the structure and function of normal heart cells lays the foundation for developing studies designed to explore the pathogenesis of diseased myocardium. Knowledge of the pathological basis of disease, with particular reference to causation, pathogenesis, and possible natural histories, is essential if the clinical manifestations of disease are to be interpreted and treated in

Many pathological states can be represented as expression of disturbances in a normal dynamic equilibrium. Myocardial ischemia may represent a condition if the blood supply to the myocardium does not meet the demand. The energy requirements of heart muscle are high. If this disturbance in the normal equilibrium persists, it triggers a cascade of cellular, inflammatory, and biochemical events, leading to the death of cardiomyocytes. Contraction of cardiomyocytes and the maintenance of their membrane integrity require large amounts of energy. Heart muscle is poorly supplied with endogenous fuel stores, is well vascularized, and is highly aerobic in its metabolism. Interruptions to the blood supply of the myocardium, even for comparatively shorts periods, produce catastrophic results.

Generation, reception, and transduction of signals at an appropriate level are intrinsic to normal cell behavior. Serious functional disturbances may arise when the cells cannot generate or transport an appropriate signal or lack the appropriate receptors to receive an important signal. Intercellular communication is fundamental for normal cardiac function. Synchronization of mechanical and electrical activity is essential to transform the work of individual myocytes into the pumping function of the organ. Desmosome is a specialized adhesive junction that interacts with the cytoskeleton and creates interactions with gap and adherens junctions. Mutations in components of the desmosome lead to a variety of disorders such as arrhythmogenic cardiomyopathy, a disease that bridges the gap between inherited

In the introductory chapter, the author discusses the importance of understanding the molecular and cellular basis of cardiovascular disease. Knowledge of the pathological basis of disease with the integration of multilevel biological data and the connection with the clinical practice reveal the potential of personalized medicine, with future implications for prognosis, diagnosis, and management of

arrhythmia syndromes and heart muscle disorders.

cardiovascular diseases.

a rational way.
