Mates M, Veselka J
Oddĕlení srdecní chirurgie Fakultní nemocnice Motol a 2. lékarské fakulty Univerzity Karlovy, Praha.
Cesk Fysiol. 1999 Feb;48(1):4-8.
The term "Hibernating myocardium" refers to the presence of a chronic left ventricular dysfunction that could be partially or completely improved after revascularization. Formerly, the myocardial hibernation was considered to be an adaptive response to a sustained reduction of the resting myocardial blood flow. Recently, several studies with positron emission tomography have revealed a normal or almost normal resting myocardial blood flow. The reduced coronary flow reserve of the hibernating myocardium brings about multiple episodes of demand-induced ischemia and may evoce recurrent stunning of the myocardium. It is the basis of structural changes in the myocardium and the contractile dysfunction. Cellular degeneration rather than adaptation prevails in the hibernating myocardium. The longer the process continues, the smaller is the chance for a complete structural and functional recovery after the reperfusion. Thus the early revascularization becomes important for the patients with hibernating myocardium.
“冬眠心肌”一词指的是存在慢性左心室功能障碍,这种功能障碍在血管重建后可能会部分或完全改善。以前,心肌冬眠被认为是对静息心肌血流量持续减少的一种适应性反应。最近,几项正电子发射断层扫描研究显示静息心肌血流量正常或几乎正常。冬眠心肌的冠状动脉血流储备降低会引发多次需求性缺血,并可能导致心肌反复顿抑。这是心肌结构改变和收缩功能障碍的基础。在冬眠心肌中,细胞变性而非适应性变化占主导。这个过程持续的时间越长,再灌注后结构和功能完全恢复的机会就越小。因此,早期血管重建对冬眠心肌患者很重要。