Document Detail

The pathological basis of myocardial hibernation.
MedLine Citation:
PMID:  12647814     Owner:  NLM     Status:  MEDLINE    
Myocardial hibernation refers to a state of persistent regional ventricular dysfunction, in patients with coronary artery disease that is reversible with revascularization. It is part of the spectrum of pathophysiological responses to myocardial ischemia and is a particularly important concept in understanding the development and progression of ischemic cardiomyopathy. Hibernating myocardium may be associated with chronic hypoperfusion, or result from repetitive episodes of ischemia with a cumulative effect on contractile function. Mechanistic studies on myocardial hibernation have been hampered by the difficulty in developing a reproducible and reliable animal model. This review describes the pathologic changes found in hibernating myocardial segments discussing the potential mechanisms involved in their development. Depletion of cardiomyocyte contractile elements, loss of myofilaments and disorganization of cytoskeletal proteins are among the most consistently reported morphological alterations found in hibernating myocardial segments. In addition, the cardiac intersitium exhibits inflammatory changes, leading to fibrotic remodeling. Induction of cytokines and chemokines suggests an active continuous inflammatory process leading to fibrosis and dysfunction. Although, the initial response may be adaptive to ischemia, if timely revascularization is not performed, irreversible tissue injury, fibrosis and myocyte degeneration may develop. Understanding the role of inflammatory mediators in the development and progression of the cardiomyopathic process may lead to the development of specific therapeutic strategies aiming at preventing irreversible fibrosis and dysfunction.
N G Frangogiannis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Histology and histopathology     Volume:  18     ISSN:  0213-3911     ISO Abbreviation:  Histol. Histopathol.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-03-21     Completed Date:  2003-09-22     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8609357     Medline TA:  Histol Histopathol     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  647-55     Citation Subset:  IM    
Section of Cardiovascular Sciences, Baylor College of Medicine and the DeBakey Heart Center, The Methodist Hospital, Houston, Texas 77030, USA.
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MeSH Terms
Coronary Circulation / physiology
Heart / physiopathology
Myocardial Contraction / physiology
Myocardial Stunning / pathology*,  physiopathology
Myocardium / pathology
Grant Support

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