Hibernating myocardium--mechanisms and clinical implications

Hibernating myocardium is defined as persistently impaired myocardial and left ventricular function at rest resulting from reduced myocardial blood flow. It is postulated that despite the reduced coronary blood flow, metabolic activity is sufficient to prevent tissue necrosis. Recovery of the hibernating myocardium has clearly been shown to occur with the establishment of successful revascularization either by coronary bypass surgery or by percutaneous transluminal coronary angioplasty. The differentiation of viable, hibernating myocardium from non-viable myocardium in patients with coronary artery disease and left ventricular dysfunction is a key issue in the current era of myocardial revascularization.