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Figure 5 Cartoon Depicting the Role of a Defective Intercellular Adhesion Complex in Infarct Rupture in Humans

In the left part of the cartoon, the normal components of the cell adhesion complex of cardiomyocytes from patients with normal infarct healing are shown. In the uninjured cardiomyocytes of normal hearts, E-catenin is localized in the intercalated disks. Ischemia induces death of the cardiomyocytes in the infarct area, as shown by the loss of their nucleus. However, the integrity of the infarct area is sufficiently preserved by the adhering cardiomyocytes, and the wound healing and granulation tissue formation continue. As shown in the right side of the cartoon, E-catenin is not localized in the intercalated disks of the cardiomyocytes in rupture-prone hearts. After ischemia, this abnormal cell adhesion complex causes the dead cardiomyocytes in the infarct area to loosen up their connections, causing further deterioration of the integrity of the infarct area and subsequently leading to infarct rupture.