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Of these, the disruption of the sarcolemma, an injury the development of which is accelerated in vivo by the contraction of viable tissue elsewhere in the heart traumatizing the ischemic area, plus the changes in high-energy phosphate and the total adenine nucleotide pool are considered to be the critical events leading to the development of irreversibility. The discovery of preconditioning with ischemia is discussed, together with a brief description of postconditioning. Finally, reperfusion injury is discussed in a summary fashion. The evidence for the fact that myocytes are salvaged by reperfusion is presented, as is the evidence that myocytes become unsalvageable by reperfusion as the duration of ischemia increases. The concept that some of the myocytes that die after successful reperfusion with arterial blood actually are killed by changes initiated by reperfusion, so-called lethal reperfusion injury, is attractive in that prevention of this change would lead to greater salvage; however, the prevalence of this phenomenon in clinical practice remains to be determined.<\/jats:p>","DOI":"10.1161\/circresaha.113.300987","type":"journal-article","created":{"date-parts":[[2013,8,1]],"date-time":"2013-08-01T20:24:39Z","timestamp":1375388679000},"page":"428-438","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":239,"title":["Historical Perspective on the Pathology of Myocardial Ischemia\/Reperfusion Injury"],"prefix":"10.1161","volume":"113","author":[{"given":"Robert B.","family":"Jennings","sequence":"first","affiliation":[{"name":"From the Department of Pathology, Duke University Medical Center, Durham, NC."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","first-page":"225","article-title":"The History of Coronary Heart Disease","author":"Leibowitz J","year":"1976","unstructured":"Leibowitz J. 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