geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Detection and characterization of hibernating myocardium


, : Detection and characterization of hibernating myocardium. Nuclear Medicine Communications 23(4): 311-322

Since Tennant and Wiggers observed that coronary occlusion caused a reduction in cardiac contractile function, a lot has been written about the concept of hibernating myocardium. Known as the 'smart heart', hibernating myocardium is characterized by a persistent ventricular myocardial dysfunction with preserved viability, which improves with the relief of the ischaemia; this chronic downregulation in contractile function being a protective mechanism to reduce oxygen demand and thus ensure myocyte survival. This improvement usually results in an enrichment in the quality of life as well as enhanced ventricular function. In fact, it has been observed that the cardiac event rate in patients with viable dysfunctional left ventricular segments who are medically treated, is higher than the event rate in patients with comparable viability who are revascularized. Different degrees of histological alteration have been seen in hibernating myocardium, ranging from cellular de-differentiation (fetal phenotype) to cellular degeneration. Cellular de-differentiation has been associated with repetitive stunning. On the other hand, cellular degeneration (with more extensive fibrosis) has been associated with chronic low myocardial blood flow and a longer time to recovery after revascularization. These histological patterns may suggest an evolution from cellular de-differentiation to degeneration, which ends in scar formation if no revascularization is performed. In fact, several studies have described the clinical value of identifying and revascularizing hibernating segments as early as possible, to minimize fibrosis and morbidity from adverse events. Detection of hibernating myocardium still remains an important clinical problem. Imaging modalities to assess myocardial viability must differentiate potentially functional tissue from myocardium with no potential for functional recovery. These techniques fall into three broad categories: ventricular function assessment, myocardial perfusion imaging and myocardial metabolic imaging. PET imaging with fluorine-18 fluorodeoxyglucose (18F-FDG) and 11C-acetate, single photon emission computed tomography (SPECT) with thallium and 99mTc-sestamibi, dobutamine echocardiograpy, magnetic resonance imaging (MRI) and fast computed tomography (CT) have been used for this purpose. PET imaging, in both perfusion and glucose metabolic activity, has become a standard for myocardial viability assessment, however, similar information may be available from carefully performed studies with perfusion tracers alone.

US$19.90

PMID: 11930184

DOI: 10.1097/00006231-200204000-00004


Other references

Chung, E.K., 1971: A reappraisal of atrial dissociation. American Journal of Cardiology 28(1): 111-117

Rao, M.; Fink, C.S.; Awad, A.B.; Venkatraman, J.T., 1996: Effects of dietary lipids on hepatic steroid metabolizing enzymes and fatty acid composition of microsomes. FASEB Journal 10(3): A490

Poelstra, K.; Bentala, H.; Verweij, W.R.; Meijer, D.K.F., 2000: Alkaline phosphatase attenuates the response of macrophages upon lipopolysaccharide ; a potential role for this enzyme during cholestasis. Hepatology 32(4 Pt 2): 198A, October

Harbeck, N.; Nimmrich, I.; Hartmann, A.; Ross, J.S.; Cufer, T.; Grützmann, R.; Kristiansen, G.; Paradiso, A.; Hartmann, O.; Margossian, A.; Martens, J.; Schwope, I.; Lukas, A.; Müller, V.; Milde-Langosch, K.; Nährig, Jörg.; Foekens, J.; Maier, S.; Schmitt, M.; Lesche, R., 2008: Multicenter study using paraffin-embedded tumor tissue testing PITX2 DNA methylation as a marker for outcome prediction in tamoxifen-treated, node-negative breast cancer patients. We recently reported DNA methylation of the paired-like homeodomain transcription factor 2 (PITX2) gene to be strongly correlated with increased risk of recurrence in node-negative, hormone receptor-positive, tamoxifen-treated breast cancer patien...

Dorff, E.N., 1996: Assisted suicide: a Jewish perspective. Sh'ma 27(517): 6-7

Wulff, R.; Abrahamsen, B.; Ejersted, C.Albjerg.; Christensen, P.Mark.; Brixen, K.T., 2004: Compliance with the treatment of osteoporosis with diphosphonates. A questionnaire among postmenopausal women. Ugeskrift for Laeger 166(1-2): 49-53

D'Amico, M.; D.F.lippo, C.; Rossi, F.; Rossi, F., 1999: Adrenoceptors modulate depressor responses of endothelin-1 into the superior colliculus of rats. Endothelin-1 (ET-1) (10 pmol) microinjected into the superficial layer of superior colliculus induces decreases in blood pressure (control, 108 +/- 5 mmHg, n=6; ET-1, 71 +/- 4 mmHg, n=5). The effects on blood pressure induced by endothelin-1 were...

Shekarriz, R.; Koulaeinejad, N.; Nosrati, A.; Salehifa, E., 2015: Sunitinib Induced Immune Thrombocytopenia. Sunitinib is an oral tyrosine kinase inhibitor which prevents tumor growth and metastatic progression. It was approved for treatment of advanced renal cell cancer, gastrointestinal stromal tumor and advanced pancreatic neuroendocrine tumors. It ha...

Corcia, P.; Lardillier, D.; Brunaud, V.; Clavelou, P.; Pouget, J.; Camu, W., 2000: High incidence of conjugal amyotrophic lateral sclerosis A role for environmental factors?. Neurology 54(7 Supp 3): A342, April 11

Hagin, Josef, 1952: The active lime content of soil as a factor in the development of chlorosis. An investigation was carried out to detn. why chlorosis appeared in certain plots and not in others on highly calcareous soils. A positive relation exists between the relative quantity of lime found within the colloidal fraction and the appearance...