Reversible and irreversible damage in reoxygenated 'ischemic' ventricular myocytes in culture

The LDH release pattern from cardiomyocytes under 'ischemia-like' conditions shows two phases. In the initial slow phase, reoxygenation immediately stops further enzyme release. Accelerated LDH release, which occurs concomitantly with Iysosomal enzyme release, characterizes the second phase of 'ischemia.' Reoxygenation at this stage does not put a stop to further enzyme release. Reoxygenation during the first phase of 'ischemia' rapidly restored ATP level, while in the second phase, ATP levels remained low even after 6 h of reoxygenation. This study as well as previous data seem to suggest that irreversible cellular damage leading to cell death, occurs by synergistic action of many effectors, each of which does not necessarily cause irreversible damage.