Increased myocardial gene expression of tumor necrosis factor-alpha and nitric oxide synthase-2: a potential mechanism for depressed myocardial function in hibernating myocardium in humans.
A self-perpetuating vicious cycle of tissue damage in human hibernating myocardium. Mol Cell Biochem 2000; 213:17-28.
Functional cine imaging comparing wall motion at rest and under stress with dobutamine unmasks hibernating myocardium
at low doses.
Nevertheless, since areas of hibernating myocardium
exist side-by-side with normal heart muscle, the disparity in electrical activity can result in rhythmic chaos, making the heart vulnerable to fatal arrhythmias.
Myocardial cell death and apoptosis in hibernating myocardium
. J Am Coll Cardiol 1997;in press.
The precise pathogenesis of stunned and hibernating myocardium
remains somewhat controversial and is beyond the scope of this article.
Therefore, a combination of techniques to evaluate several of these parameters is generally used clinically in considering if repetitively stunned or hibernating myocardium
exists as a cause of reversible left ventricular dysfunction, warranting coronary revascularization.
The [beta]-blocker also might shift the energy substrate of the myocardium away from free fatty acids and toward glucose; that would further improve efficiency, especially in hibernating myocardium
, they said.
Bonow suggested that these patients may have a large amount of hibernating myocardium
that is salvaged by revascularization.