Metabolic and Mitochondrial Changes in the Failure Condition of Myocardial Hibernation: Present Understanding, Existing Controversies, and Future Genetic Approaches

• Published in: Advances in Organ Biology Vol. 4; pp. 193 - 209
• Main Author: Liedtke, A. James
• Format: Book Chapter
• Language: English
• Published: Elsevier B.V 1998
• ISBN: 9780762303892; 0762303891
• ISSN: 1569-2590
• DOI: 10.1016/S1569-2590(08)60091-9

This chapter discusses the present understanding, existing controversies, and future genetic approaches on metabolic behavior of hibernating myocardium. The value of hibernation as a model of heart failure is in the wealth of metabolic information that has become available. One therapeutic benefit to empirically emerge from the preserved glucose uptake of hibernating myocardium was its predictive value in estimating reversibility of mechanically dysfunctional myocardium to normal or near normal contractile states after revascularization. The chief conflict in understanding hibernating myocardium is the flow perturbation that is responsible for affecting the down regulation in mechanical function. The chapter discusses animal models and their relevance in understanding hibernating myocardium. Implicit in the animal studies and possibly the clinical studies described in this chapter are the presumptions that the decline in contractility precipitated by demand ischemia and lost coronary reserve also exposed the myocardium to appreciable regional stretch.