Related Experiment Video

Updated: Aug 19, 2026

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery
09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

The contribution of hibernation to heart failure

Paolo G Camici1, Ornella E Rimoldi

  • 1MRC Clinical Sciences Centre, Hammersmith Hospital, Ducane Road, London W12 ONN, UK. paolo.camici@csc.mrc.ac.uk

Annals of Medicine
|October 30, 2004
PubMed

Insights

Coronary revascularisation can improve heart function in patients with coronary artery disease and heart failure by restoring blood flow to hibernating myocardium. This viable heart muscle recovers function after treatment, challenging the idea of irreversible damage.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Viability

Background:

  • Chronic coronary artery disease (CAD) was historically thought to cause irreversible heart damage.
  • Recent evidence suggests that functional sequelae of CAD may be reversible.
  • Coronary revascularisation (CR) shows promise in improving outcomes for patients with CAD and heart failure.

Purpose of the Study:

  • To explore the concept of reversible myocardial dysfunction in chronic coronary artery disease.
  • To investigate the role of hibernating myocardium (HM) in the benefits of CR.
  • To discuss the diagnostic capabilities of cardiac imaging in identifying HM.

Main Methods:

  • Review of non-randomised studies on coronary revascularisation in CAD and heart failure.
  • Analysis of cardiac imaging techniques (echocardiography, SPECT, PET, MRI) for HM identification.
  • Examination of PET findings regarding myocardial blood flow and coronary flow reserve in HM.

Main Results:

  • CR confers symptomatic and prognostic benefits in patients with CAD and heart failure.
  • Recovery of contractile function in hibernating myocardium is a key mechanism for CR benefits.
  • Cardiac imaging effectively identifies HM, with comparable predictive values for moderate left ventricular impairment.
  • PET studies reveal preserved resting myocardial blood flow but impaired coronary flow reserve in HM.

Conclusions:

  • The functional deficits in chronic CAD may not be irreversible.
  • Hibernating myocardium plays a crucial role in the recovery of cardiac function after CR.
  • The pathophysiology of HM is complex, involving preserved blood flow but reduced coronary flow reserve.
  • Stunning and HM may represent different manifestations of ischaemic myocardial injury.

More Related Videos

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model08:22

In vitro Assessment of Myocardial Protection following Hypothermia-Preconditioning in a Human Cardiac Myocytes Model

Published on: October 27, 2020

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models07:49

A Pacing-Controlled Procedure for the Assessment of Heart Rate-Dependent Diastolic Functions in Murine Heart Failure Models

Published on: July 21, 2023

Related Concept Videos

Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
Heart Failure III: Clinical Manifestations01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...