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Hibernating myocardium: its pathophysiology and clinical role
R Ferrari1, F Ferrari, M Benigno
1Cattedra di Cardiologia, Universita' degli Studi di Brescia, Italy.
Myocardial hibernation, a reversible contractile dysfunction in coronary artery disease, may be an adaptive response to ischemia. Its precise mechanisms remain elusive but involve protective phenomena like stunning and preconditioning.
Area of Science:
- Cardiology
- Physiology
Background:
- Myocardial hibernation is chronic contractile dysfunction in coronary artery disease, reversible by reperfusion.
- Conditions like angina, myocardial infarction, and heart failure can present with hibernation.
Purpose of the Study:
- To explore the mechanisms and clinical relevance of myocardial hibernation.
- To investigate the adaptive nature of hibernation during ischemia.
Main Methods:
- Review of clinical conditions associated with myocardial hibernation.
- Analysis of postulated mechanisms, including energy regulation and protective phenomena.
- Evaluation of experimental evidence regarding hibernation, stunning, and preconditioning.
Main Results:
- Morphological alterations in hibernating myocardium are influenced by diagnostic criteria.
- Hibernation may be a regulatory event to reduce energy expenditure during ischemia.
- Experimental evidence suggests hibernation, stunning, and preconditioning are adaptive, protective phenomena.
Conclusions:
- The exact mechanisms of myocardial hibernation in humans are difficult to ascertain due to study limitations.
- Hibernation, stunning, and preconditioning are likely adaptive and protective responses to myocardial ischemia.
- These phenomena contribute to reversible regional myocardial contractile dysfunction.
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