Membrane Damage in Ischemia
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Our studies have evaluated the hypothesis that progressive membrane damage, particularly to the plasma membrane, is a major factor in the evolution of myocardial ischemic and hypoxic injury and in particular the conversion from reversible to irreversible injury. A proposed schema of progressive membrane injury involves sequential changes characterized by: a) altered flux and distribution of monovalent ions and water leading to loss of cellular potassium, increase in cell sodium, chloride and water, and cell swelling and edema; b) altered flux and distribution of polyvalent ions, including calcium, associated with further impairment in cellular integrity, and c) physical defects in membrane integrity in severely damaged cells [4, 28]. The first two alterations (a and b) could involve alterations in specific membrane transport systems or, conversely, non-specific changes in membrane permeability. The former catagory includes potential alterations in sodium-potassium ATPase, the slow calcium channel, the sodium-calcium exchange system, and other such specific membrane systems. Alternatively, the pathophysiologic changes could result from progressive increases in membrane fluidity and permeability induced by changes in the phospholipid bilayer of the membrane.
KeywordsPapillary Muscle Coronary Occlusion Membrane Phospholipid Composition Severe Structural Damage Topographical Correlation
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