Ischemia/Reperfusion Injury following Acute Myocardial Infarction: A Critical Issue for Clinicians and Forensic Pathologists

Figure 1

Schematic representation of calpain activation during myocardial IRI. Ca²⁺ overload and pH recovery in reperfusion phase are crucial in the activation of the calpain system. Increased sarcolemmal fragility may lead to membrane rupture and cell death. In addition, both the death-receptor and mitochondrial mediated apoptotic pathways seem to be affected by calpain activation. The degradation of myofibrillar proteins and the loss/disorganization of T-tubules structure are key factors in post-MI heart failure development.