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Blood flow in myocardial hibernation
1MRC Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom.
Current Opinion in Cardiology
|November 21, 1998
Summary
Myocardial hibernation, a persistent heart dysfunction in coronary artery disease, may stem from repeated myocardial stunning, not just reduced blood flow. This dysfunction can improve with revascularization treatments.
Area of Science:
- Cardiology
- Physiology
Background:
- Myocardial hibernation is impaired left ventricular function in coronary artery disease, improving post-revascularization.
- Traditionally attributed to chronic reduced myocardial blood flow.
- Recent positron emission tomography studies show normal blood flow in hibernating myocardium.
Purpose of the Study:
- To investigate the hypothesis that repetitive myocardial stunning causes myocardial hibernation.
- To explore the role of reversible contractile dysfunction after ischemia in hibernation.
Main Methods:
- Review of recent positron emission tomography studies.
- Analysis of evidence for repetitive myocardial stunning.
- Comparison of stunning and hibernation clinical presentations.
Main Results:
- Absolute myocardial blood flow in hibernating myocardium is often within normal limits.
- Repetitive myocardial stunning, reversible contractile dysfunction post-ischemia, is implicated.
- Evidence suggests cumulative left ventricular dysfunction from repeated ischemia.
Conclusions:
- Myocardial hibernation may result from repetitive myocardial stunning rather than solely reduced blood flow.
- Understanding this mechanism could refine treatment strategies for coronary artery disease.