[The "stunned" and "hibernating myocardium"--diagnosis and clinical implications].

Myocardial stunning and myocardial hibernation gain increasing importance for the therapy of myocardial ischemia. It has been demonstrated that myocardial stunning may be reversible after successful reperfusion, although this may need weeks or even months. Similarly, noncontracting myocardial areas may regain contractile properties after successful dilatation of high grade stenoses or after bypass operation (myocardial hibernation). The diagnosis of myocardial stunning or myocardial hibernation usually is made by nuclear medicine (201Tl or 99Tc-MIBI). 201Tl-Imaging after 24 hours or after reinjection seems to be the best method to prove myocardial hibernation. Dobutamine stress echocardiography may gain importance in the future.