Myocardial Injury and Repair
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Reperfusion of the ischaemic myocardium has evolved as the most efficient treatment in patients with impending infarction. The methods of choice are either angioplasty or thrombolysis. The success of the procedure depends on the duration and degree of ischaemia—i.e. whether ischaemic injury is still reversible or not. The susceptibility of human hearts to ischaemic injury varies, depending on the interplay of the five variables known to influence the size of an infarct and the speed of its development (Müller et al., 1982; Schaper, 1984). Thus, in one patient reperfusion after ischaemia may result in recovery of the ischaemic tissue, whereas in another reperfusion may produce haemorrhagic necrosis. Animal models of this clinical situation provide insights into the precise mechanisms active in either recovery or the development of necrosis and allow for the investigation of detailed aspects such as the role of blood cells in reperfused ischaemic myocardium. In this study we describe the morphological changes typical of ischaemic and ischaemic-reperfused myocardium, with particular emphasis on the role of blood cells and its possible regulation by adhesion molecules and integrins.
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