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• W2076248868 abstract "Hibernation was first described by Diamond et al 1 Diamond G.A Forrester J.S deLuz P.L Wyatt H.L Swan H.J Post-extrasystolic potentiation of ischemic myocardium by atrial stimulation. Am Heart J. 1978; 95: 204-209 Abstract Full Text PDF PubMed Scopus (136) Google Scholar in 1978 as regional left ventricular (LV) dysfunction that recovers after coronary revascularization. The term was subsequently popularized by Rahmitoola. 2 Rahimtoola S.H The hibernating myocardium. Am Heart J. 1989; 117: 211-221 Abstract Full Text PDF PubMed Scopus (1075) Google Scholar , 3 Rahimtoola S.H A perspective on the three large multicenter randomized clinical trials of coronary bypass surgery for chronic stable angina. Circulation. 1985; 72: V-123-V-135 Google Scholar The term “stunning” was initially introduced by Heyndrickx et al 4 Heyndrickx G.R Millard R.W McRitchie R.J Maroko P.R Vatner S.F Regional myocardial functional and electrophysiological alterations after brief coronary artery occlusion in conscious dogs. J Clin Invest. 1975; 56: 978-985 Crossref PubMed Scopus (772) Google Scholar in 1975 and then popularized by Braunwald and Kloner. 5 Braunwald E Kloner R.A The stunned myocardium prolonged, post-ischemic ventricular dysfunction. Circulation. 1982; 66: 1146-1149 Crossref PubMed Scopus (2369) Google Scholar It refers to postischemic dysfunction characterized by flow-function mismatch (normal flow but reduced function) in the absence of myocardial necrosis. Myocardial hibernation, stunning, remodeling, and scarring may result in regional LV dysfunction in patients with coronary artery disease (CAD). If the dysfunction is severe and extensive, it may lead to depression of LV ejection fraction (EF) and heart failure. Hibernation is thought to represent a flow-function match where there is compensatory down-regulation of function to match the reduced myocardial blood flow and the process is reversible with coronary revascularization. 6 Kloner R.A Bolli R Marban E Reinlib L Braunwald E Medical and cellular implications of stunning, hibernation and preconditioning. An NHLBI Workshop. Circulation. 1998; 97: 1848-1867 Crossref PubMed Scopus (395) Google Scholar , 7 Camici P.G Wijns W Borgers M De Silva R Ferrari R Knuuti J Lammertsma A.A Liedtke A.J Paternostro G Vatner S.F Pathophysiological mechanisms of chronic reversible left ventricular dysfunction due to coronary artery disease (hibernating myocardium). Circulation. 1997; 96: 3205-3214 Crossref PubMed Scopus (140) Google Scholar , 8 Vanoverschelde J.L Wijns W Borgers M Heyndrickx G Depr J.C Flameng W Melin J.A Chronic myocardial hibernation in humans. From bedside to bench. Circulation. 1997; 95: 1961-1971 Crossref PubMed Scopus (199) Google Scholar , 9 Marinho N.V Keogh B.E Costa D.C Lammerstma A.A Ell P.J Camici P.G Pathophysiology of chronic left ventricular dysfunction. New insights from the measurement of absolute myocardial blood flow and glucose utilization. Circulation. 1996; 93: 737-744 Crossref PubMed Scopus (197) Google Scholar , 10 Elsässer A Schlepper M Klövekorn W.P Cai W.J Zimmermann R Müller K.D Strasser R Kostin S Gagel C Munkel B Schaper W Schaper J Hibernating myocardium an incomplete adaptation to ischemia. Circulation. 1997; 96: 2920-2931 Crossref PubMed Scopus (309) Google Scholar , 11 Sambuceti G Giorgetti A Corsiglia L Marini C Schneider-Eicke J Brunelli C Marzullo P L’Abbate A Capponnetto S Parodi O Perfusion-contraction mismatch during inotropic stimulation in hibernating myocardium. J Nucl Med. 1998; 39: 396-402 PubMed Google Scholar , 12 Iskandrian A.S Heo J Schelbert H.R Myocardial viability methods of assessment and clinical relevance. Am Heart J. 1996; 132: 1226-1235 Abstract Full Text PDF PubMed Scopus (28) Google Scholar Several studies, however, have shown that resting myocardial blood flow is normal in dysfunctional segments, although coronary blood flow reserve is diminished. 6 Kloner R.A Bolli R Marban E Reinlib L Braunwald E Medical and cellular implications of stunning, hibernation and preconditioning. An NHLBI Workshop. Circulation. 1998; 97: 1848-1867 Crossref PubMed Scopus (395) Google Scholar , 7 Camici P.G Wijns W Borgers M De Silva R Ferrari R Knuuti J Lammertsma A.A Liedtke A.J Paternostro G Vatner S.F Pathophysiological mechanisms of chronic reversible left ventricular dysfunction due to coronary artery disease (hibernating myocardium). Circulation. 1997; 96: 3205-3214 Crossref PubMed Scopus (140) Google Scholar , 8 Vanoverschelde J.L Wijns W Borgers M Heyndrickx G Depr J.C Flameng W Melin J.A Chronic myocardial hibernation in humans. From bedside to bench. Circulation. 1997; 95: 1961-1971 Crossref PubMed Scopus (199) Google Scholar , 13 Tillisch J Brunken R Marshal R Schwaiger M Mandelkern M Phelps M Schelbert H Reversibility of cardiac wall motion abnormalities predicted by positron emission tomography. N Engl J Med. 1986; 314: 884-888 Crossref PubMed Scopus (1108) Google Scholar , 14 Fallavollita J.A Perry B.J Canty Jr, J.M 18F-2-Deoxyglucose deposition and regional flow in pigs with chronically dysfunctional myocardium. Evidence for transmural variations in chronic hibernating myocardium. Circulation. 1997; 95: 1900-1909 Crossref PubMed Scopus (146) Google Scholar The dysfunction has been considered to represent repetitive stunning. In the original study by Tillish et al, 13 Tillisch J Brunken R Marshal R Schwaiger M Mandelkern M Phelps M Schelbert H Reversibility of cardiac wall motion abnormalities predicted by positron emission tomography. N Engl J Med. 1986; 314: 884-888 Crossref PubMed Scopus (1108) Google Scholar 63% of dysfunctional segments that recovered after coronary revascularization exhibited normal myocardial blood flow and normal F-18 fluorodeoxyglucose (FDG) pattern suggestive of stunning and 37% showed flow-metabolism mismatch pattern suggestive of hibernation. Both hibernation and stunning are important and may coexist in the same patient or in the same myocardial segment. There are mild to severe structural and biochemical changes including apoptosis in hibernating myocardium that may affect not only the rate but also the completeness of recovery of LV function after coronary revascularization. 7 Camici P.G Wijns W Borgers M De Silva R Ferrari R Knuuti J Lammertsma A.A Liedtke A.J Paternostro G Vatner S.F Pathophysiological mechanisms of chronic reversible left ventricular dysfunction due to coronary artery disease (hibernating myocardium). Circulation. 1997; 96: 3205-3214 Crossref PubMed Scopus (140) Google Scholar , 8 Vanoverschelde J.L Wijns W Borgers M Heyndrickx G Depr J.C Flameng W Melin J.A Chronic myocardial hibernation in humans. From bedside to bench. Circulation. 1997; 95: 1961-1971 Crossref PubMed Scopus (199) Google Scholar , 9 Marinho N.V Keogh B.E Costa D.C Lammerstma A.A Ell P.J Camici P.G Pathophysiology of chronic left ventricular dysfunction. New insights from the measurement of absolute myocardial blood flow and glucose utilization. Circulation. 1996; 93: 737-744 Crossref PubMed Scopus (197) Google Scholar , 15 Chen C Ma L Linfert D.R Lai T Fallon J.T Gillam L.D Waters D.D Tsongalis G.J Myocardial cell death and apoptosis in hibernating myocardium. J Am Coll Cardiol. 1997; 30: 1407-1412 Abstract Full Text Full Text PDF PubMed Scopus (95) Google Scholar In patients with more severe abnormalities, ≥6 months may be required for functional recovery. These histologic and biochemical changes may also be one of the mechanisms for lack of contractile response to inotropic stimulation. This topic has been extensively reviewed recently. 6 Kloner R.A Bolli R Marban E Reinlib L Braunwald E Medical and cellular implications of stunning, hibernation and preconditioning. An NHLBI Workshop. Circulation. 1998; 97: 1848-1867 Crossref PubMed Scopus (395) Google Scholar , 7 Camici P.G Wijns W Borgers M De Silva R Ferrari R Knuuti J Lammertsma A.A Liedtke A.J Paternostro G Vatner S.F Pathophysiological mechanisms of chronic reversible left ventricular dysfunction due to coronary artery disease (hibernating myocardium). Circulation. 1997; 96: 3205-3214 Crossref PubMed Scopus (140) Google Scholar , 8 Vanoverschelde J.L Wijns W Borgers M Heyndrickx G Depr J.C Flameng W Melin J.A Chronic myocardial hibernation in humans. From bedside to bench. Circulation. 1997; 95: 1961-1971 Crossref PubMed Scopus (199) Google Scholar The purpose of this review is to summarize outcome data based on viability assessment and to provide perspectives for future studies." @default.
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• W2076248868 date "1999-03-01" @default.
• W2076248868 modified "2023-09-25" @default.
• W2076248868 title "Prognostic utility of myocardial viability assessment" @default.
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• W2076248868 doi "https://doi.org/10.1016/s0002-9149(98)00973-4" @default.
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