The role of neurohormonal antagonists in hibernating myocardium

Hibernating myocardium is characterized by chronic reduction of myocardial blood flow due to obstructive coronary artery disease, causing reversible left ventricular dysfunction and flow-metabolism mismatch. The condition is unstable and increasing demand may lead to further left ventricular dysfunction or necrosis causing death or worsening heart failure. Recognition of the condition is difficult and requires complex cardiac imaging protocols. Treatment protocols are also poorly defined. This review addresses both the diagnostic and therapeutic aspects of hibernating myocardium.