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Myocardial ultrastructure were investigate after irreversible ischemia, induced by left descendent coronary artery occlusion in rat hearts, and after ischemia/reperfusion. Ultrastructural analysis revealed significant differences in the pathways of cardiomyocyte death after irreversible ischemia and after ischemia/repefusion. Semax, given i. p. 15 min and 2 hour after coronary occlusion, completely prevented ischemia-induced ultrastructural changes in cardiomyocytes, primarily in the mitochondria.