[Regenerative and plastic heart failure: molecular biological mechanisms and morphological bases]

Regenerative and plastic heart failure resulted in impaired or inhibited biosynthetic processes (plastic metabolism) and hence decreased or ceased intracellular cardiomyocytic regeneration. Atrophic (involutional) processes of cardiomyocytes and their progressive deficiency due to apoptotic death (diffuse cardiomyocytic depopulation), accompanied by the development of diffuse cardiosclerosis play the key role in regenerative and plastic heart failure. Diffuse myocardial sclerosis may be regarded as a corrected compensatory connective tissue response to a pronounced decrease in muscle fiber mass. In anthracycline-induced cardiomyopathy, myocardial remodeling as a result of changes in the pattern of parenchymal and stromal interactions occurs in the dilatation mode and induces no severe cardiac deformation, which is a favorable factor in restoring the normal myocardial architectonics when regenerative processes are resumed.