Delineation of myocardial stunning and hibernation by positron emission tomography in advanced coronary artery disease

American Heart Journal
A ConversanoR J Gropler

Abstract

With positron emission tomography, the resting flow abnormalities underlying reversible left ventricular dysfunction in 17 patients with chronic coronary artery disease were delineated. The level of flow in reversible dysfuncTional segments (i.e., those demonstrating improvement after revascularization) was markedly variable, ranging from 0.32 to 1.25 ml/gm/min. In 20 of these segments, flow was preserved, whereas in 12 segments, flow was reduced, when compared with that in, age-matched controls. Preservation of flow was associated with preservation of myocardial oxygen consumption and no alterations in myocardial substrate use. In contrast, a reduction in flow resulted in a decrease myocardial oxygen consumption and an increase in myocardial glucose use. Thus resting reversible left ventricular dysfunction in patients with chronic coronary artery disease can reflect a diversity of resting flow abnormalities. Moreover, myocardial perfusion at rest is frequently within normal limits, suggesting that the reversible mechanical dysfunction in these patients is attributable to intermittent myocardial stunning and not hibernation.

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Citations

Dec 10, 2003·Current Cardiology Reports·Robert J Gropler, Pablo Soto
Jul 17, 1998·The New England Journal of Medicine·W WijnsP G Camici
Jul 10, 2013·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Jeffrey M C LauPamela K Woodard
May 15, 2009·The American Journal of the Medical Sciences·Dalton S McLeanStamatios Lerakis
Oct 22, 2011·Progress in Cardiovascular Diseases·Suchi GroverJoseph B Selvanayagam
Jan 1, 2009·PET Clinics·Robert J Gropler
Mar 18, 1999·The American Journal of Cardiology·S Iskander, A E Iskandrian
Oct 23, 2003·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Chang-Min ChungOsamu Katoh
Dec 10, 1999·Journal of the American College of Cardiology·B ShivalkarJ Vanhaecke
Jun 18, 2016·Journal of the American College of Cardiology·Nandan S AnavekarBernard J Gersh
Dec 13, 2003·Circulation Research·Katherine C Wu, João A C Lima
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