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Titolo:
HIBERNATING MYOCARDIUM
Autore:
HEUSCH G;
Indirizzi:
UNIV ESSEN GESAMTHSCH,SCH MED,CTR INTERNAL MED,DEPT PATHOPHYSIOL ESSEN GERMANY
Titolo Testata:
Physiological reviews
fascicolo: 4, volume: 78, anno: 1998,
pagine: 1055 - 1085
SICI:
0031-9333(1998)78:4<1055:>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
LEFT-VENTRICULAR DYSFUNCTION; CORONARY-ARTERY DISEASE; POSITRON EMISSION TOMOGRAPHY; LOW-FLOW ISCHEMIA; LOW-DOSE DOBUTAMINE; SHORT-TERM HIBERNATION; REDISTRIBUTION TL-201 TOMOGRAPHY; REPERFUSED CANINE MYOCARDIUM; WALL-MOTION ABNORMALITIES; HIGH-ENERGY PHOSPHATES;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
222
Recensione:
Indirizzi per estratti:
Citazione:
G. Heusch, "HIBERNATING MYOCARDIUM", Physiological reviews, 78(4), 1998, pp. 1055-1085

Abstract

Decreased myocardial contraction occurs as a consequence of a reduction in blood flow. The concept of hibernation implies a downregulation of contractile function as an adaptation to a reduction in myocardial blood flow that serves to maintain myocardial integrity and viability during persistent ischemia. Unequivocal evidence for this concept exists in scenarios of myocardial ischemia that lasts for several hours, and sustained perfusion-contraction matching, recovery of energy and substrate metabolism, the potential for recruitment of inotropic reserveat the expense of metabolic recovery, and lack of necrosis are established criteria of short-term hibernation. The mechanisms of short-termhibernation, apart from reduced calcium responsiveness, are not clearat present. Experimental studies with chronic coronary stenosis lasting more than several hours have failed to continuously monitor flow and function. Nevertheless, a number of studies in chronic animal modelsand patients have demonstrated regional myocardial. dysfunction at reduced resting blood flow that recovered upon reperfusion, consistent with chronic hibernation. Further studies are required to distinguish chronic hibernation from cumulative stunning. With a better understanding of the mechanisms underlying short-term hibernation, it is hoped that these adaptive responses can be recruited and reinforced to minimize the consequences of acute myocardial ischemia and delay impending infarction. Patients with chronic hibernation must be identified and undergo adequate reperfusion therapy.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 07:30:23