The pathological basis of myocardial hibernation

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)647-655
Number of pages9
JournalHistology and Histopathology
Volume18
Issue number2
StatePublished - Apr 2003
Externally publishedYes

Fingerprint

Myocardial Stunning
Fibrosis
Ischemia
Ventricular Dysfunction
Cytoskeletal Proteins
Myofibrils
Cardiomyopathies
Chemokines
Cardiac Myocytes
Muscle Cells
Myocardial Ischemia
Coronary Artery Disease
Myocardium
Animal Models
Cytokines
Wounds and Injuries
Therapeutics

Keywords

  • Chemokine
  • Fibrosis
  • Hibernation
  • Ischemia
  • Myocardium

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Histology
  • Cell Biology

Cite this

The pathological basis of myocardial hibernation. / Frangogiannis, Nikolaos G.

In: Histology and Histopathology, Vol. 18, No. 2, 04.2003, p. 647-655.

Research output: Contribution to journalArticle

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