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Figure 3 The degree of perioperative myocardial injury is a result of the balance between injurious and cardioprotective (endogenous and exogenous) biological mechanisms, mediated via a wide array of biochemical pathways with extensive genetic variability. AR = adrenergic receptor; CPB = cardiopulmonary bypass; EC = endothelial cells; PMN = polymorphonuclear neutrophils; RNS = reactive nitrogen species; ROS = reactive oxygen species.