Key result
The calcium paradox causes irreversible damage to myocyte membranes upon reperfusion with calcium after a calcium-free period, which can be mitigated by hypothermia, hyponatremia, or trace calcium.
This review highlights the mechanisms of the calcium paradox in heart muscle cells and identifies strategies such as calcium channel blockers and hypothermia to prevent reperfusion injury.
May inform myocardial protection strategies during reperfusion; leaves open prospective clinical validation.
The calcium paradox was first mentioned in 1966 by Zimmerman et al. Thereafter gained great interest from the scientific community due to the fact of the absence of calcium ions in heart muscle cells produce damage similar to ischemia-reperfusion. Although not all known mechanisms involved in cellular injury in the calcium paradox intercellular connection maintained only by nexus seems to have a key role in cellular fragmentation. The addition of small concentrations of calcium, calcium channel blockers, and hyponatraemia hypothermia are important to prevent any cellular damage during reperfusion solutions with physiological concentration of calcium.
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Oliveira et al. (2014) conducted a review in Calcium paradox / Myocardial Ischemia. Calcium-free cardioplegia followed by calcium reperfusion was evaluated. The calcium paradox causes irreversible damage to myocyte membranes upon reperfusion with calcium after a calcium-free period, which can be mitigated by hypothermia, hyponatremia, or trace calcium.
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