[Myocardial reperfusion: salvation or danger for the heart muscle? Stunning, hibernation and preconditioning: the states of endogenous cardiac protection against ischemia].

During most of our decade myocardial ischemia was regarded as an all-or-nothing phenomenon, either resulting in myocardial necrosis in case of severe and prolonged ischemia, or in negligible changes when ischemia was transient and mild. This view has been challenged in the wake of new discoveries during the last 15 years which indicate that depressed myocardial contractility with preserved viability may exist during or following ischemic insults. The clinical and pathophysiologic characteristics of these ischemic myocardial syndromes--stunning, hibernation and preconditioning--are discussed in the present overview.