[Mechanisms of progression in heart failure]

A fundamental structural event in the progression of heart failure is myocardial remodeling. New mechanisms have been identified to be related with the cellular and molecular process of remodeling. The interaction between the multiple intracellular and extracellular signaling pathways have been recognized to be crucial for understanding the mechanisms that lead to the transition between cardiac hypertrophy and heart failure. Thus, the goal of this review is to summarize recent findings regarding the molecular and cellular mechanisms involved in the failing heart. The role of apoptosis, extracellular matrix, biochemical and molecular changes, signaling pathways, cytokines, inflammatory response and gene expression are discussed as well as the new possible alternatives for therapy.