Figure 6.

Pathway of hypoxia-acidosis mediated cell death in cardiac myocytes. BNIP3 protein is expressed by hypoxia but accumulates and induces mitochondrial dysfunction as the pH declines. Calcium release from both the mitochondria and sarcoplasmic reticulum activates calpains which leads to caspase inactivation and protease and DNase activation and cell death. Broken lines indicate where the death pathway can be inhibited. SR is sarcoplasmic reticulum.