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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 67 (1989), S. 465-476 
    ISSN: 1432-1440
    Keywords: Myocardial ischemia ; Reperfusion injury ; Oxygen paradox ; Contracture ; Calcium ; Oxygen radicals ; ATP
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary After prolonged ischemia or hypoxia myocardial injury is not reversed but exacerbated by a resupply of the tissue with oxygen and substrates. The mechanism by which reversible ischemic or hypoxic myocardial injury becomes irreversible is not yet understood. It has been debated whether “reperfusion injury” merely uncovers pre-existing irreversible injury, or is indeed caused by the reperfusion/reoxygenation process. In recent years, three theories have been discussed that relate the onset of irreversibility either to: a critical energy loss; a critical accumulation of cellular calcium; or to the deleterious effects of free radical formation. In certain experimental models for each of these theories favourable results have been obtained. Current research suggests that absolute reversibility thresholds in energy depletion or calcium accumulation in the ischemic or hypoxic cell do not exist. A key role of free radical injury for reperfusion injury must also be questioned. There is, however, evidence that in tissue reversibility of ischemic cardiomyocyte injury is limited by conditions that make calcium-induced hypercontracture upon reoxygenation unavoidable. This occurs when, by hypercontracture, mutual mechanical disruption of the cells destroys the tissue. From isolated cardiomyocytes that are able to metabolically survive hypercontracture it has been observed that these metabolic conditions do not represent the last biological possibility to reverse injury.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Basic research in cardiology 88 (1993), S. 471-482 
    ISSN: 1435-1803
    Keywords: Calcium ; sodium ; sodium-calcium exchange ; reperfusion injury ; 2,3-butanedione monoxime
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary When oxygen-deprived cardiomyocytes become energy depleted, they accumulate Na+ and Ca2+ in the cytosol. Influx of Ca2+ via the Na+/Ca2+ exchange mechanism seems to contribute to the development of Ca2+ overload, but Ca2+ overload may eventually also occur when this route is blocked. Hypoxic-reoxygenated cardiomyocytes in a state of severe overload of Na+ and Ca2+ can rapidly re-establish a normal cation control when oxidative energy production is re-initiated. The recovery of cellular Ca2+ control may be devided into three stages: first, sequestration of large amounts of Ca2+ into the sarcoplasmic reticulum; second, oscillatory movement of Ca2+ from and back into the sarcoplasmic reticulum and gradual extrusion across the sarcolemma; third, re-establishment of constant low cytosolic Ca2+ concentrations. When the Na+/Ca2+ exchanger is inhibited, extrusion of Ca2+ from the cells' interior is impaired and oscillatory Ca2+ movements between cytosol and sarcoplasmic reticulum continue for long time. Thus, the functions of the sarcoplasmic reticulum and the Na+/Ca2+ exchanger are of crucial importance for the recovery of Ca2+ control in reoxygenated cardiomyocytes. In re-energized cardiomyocytes, a persistent elevation of the cytosolic Ca2+ concentration provokes maximal force development and consecutive mechanical cell injury (“oxygen paradox”). This injury can be prevented when the contractile machinery is inhibited during the initial phase of reoxygenation as long as necessary for the re-establishment of a normal cytosolic Ca2+ control.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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