Camici P G, Rimoldi O
MRC Cyclotron Unit, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom.
Curr Opin Cardiol. 1998 Nov;13(6):409-14. doi: 10.1097/00001573-199811000-00005.
Myocardial hibernation is a state of persistently impaired left ventricular function in patients with coronary artery disease that improves after revascularization. It was thought to be caused by a chronic reduction in resting myocardial blood flow in a segment subtended by a diseased coronary artery. However, recent studies using positron emission tomography have demonstrated that absolute myocardial blood flow (mL/min/g) to hibernating myocardium is within normal limits in most patients. The authors hypothesize that hibernating myocardium may be the result of repetitive myocardial stunning, that is, the reversible contractile dysfunction occurring after an episode of myocardial ischemia despite the return of blood flow to normal. Myocardial stunning has been demonstrated in humans in different clinical settings, and recent studies have provided evidence that repetitive episodes of exercise induced ischemia can lead to cumulative and prolonged left ventricular dysfunction akin to that observed in hibernating myocardium.
心肌冬眠是指冠状动脉疾病患者左心室功能持续受损的一种状态，血运重建后功能可改善。过去认为它是由病变冠状动脉所支配节段的静息心肌血流长期减少所致。然而，最近使用正电子发射断层扫描的研究表明，大多数患者中冬眠心肌的绝对心肌血流量（毫升/分钟/克）在正常范围内。作者推测，冬眠心肌可能是反复心肌顿抑的结果，即心肌缺血发作后尽管血流恢复正常但仍出现的可逆性收缩功能障碍。在不同临床情况下，人类已证实存在心肌顿抑，最近的研究提供了证据表明，运动诱发的缺血反复发作可导致累积性和持续性左心室功能障碍，类似于在冬眠心肌中观察到的情况。
