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This dramatic increase is exacerbated by factors unique to the reperfused myocardium, including calcium overload, rapid restoration of mitochondrial electron transport, activation of enzymes like NADPH oxidase and xanthine oxidase, and the infiltration of inflammatory cells that release a wide array of oxidants (Liu N

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Each stage hinges on a balance of pro-inflammatory versus anabolic cues: mild to moderate inflammation is vital for debris clearance and immune surveillance, whereas growth factors and mechanical stimuli drive fibroblasts and chondrocytes to rebuild a durable matrix