Last update:
17-Sep-2004

The concept of hibernation implies a down regulation of contractile function as an adaptation to a reduction in myocardial blood flow which serves to maintain myocardial integrity and viability during persistent ischemia. Viable, chronically dysfunctional myocardium may have normal or reduced resting flow. The ischemia-induced ventricular dysfunction, at least initially, is reversible as early reperfusion of the myocardium results in restoration of normal metabolism and contraction. Myocardial hibernation has been documented in patients with angina (chronic stable and/or unstable), acute myocardial infarction, heart failure and/or severe left ventricular dysfunction, and anomalous left coronary artery from the pulmonary artery. Established diagnostic tests for its recognition include dobutamine echocardiography, thallium and sestamibi scintigraphy and positron emission tomography. Revascularization, either by surgery or by interventional catheter techniques, if performed in time, has been shown to improve or normalize the abnormal left ventricular function at rest.

Key words: Coronary artery disease, Coronary flow, Hibernating myocardium, Revascularization.