• Presse Med · Jun 1998

    Review

    [Myocardial viability. The concept of myocardial viability].

    • J C Cachin.
    • Fédération de Cardiologie, Hôpital Henri Mondor, Créteil.
    • Presse Med. 1998 Jun 13; 27 (21): 1038-42.

    Myocardial ViabilityCertain zones of ischemic, akinetic or severely hypokinetic myocardium are capable of recovering normal contractile function. This is termed myocardial viability and occurs in two different situations: myocardial stunning and myocardial hibernation.Myocardial StunningThis term designates temporary but prolonged impairment of myocardial function resulting from a brief episode of ischemia before reperfusion.Myocardial HibernationHibernation designates prolonged but potentially reversible myocardial contractile dysfunction caused by chronic myocardial ischemia and persisting at least until blood flow is restored.Clinical ConsequencesTheoretically reversible, myocardial stunning or hibernation can have devastating effects if they persist too long. Revascularization with angioplasty or bypass surgery is indicated.DiagnosisThe degree of myocardial viability in akinetic zones can be determined by assessing preserved inotropic capacity with stress echocardiography and/or evidencing metabolic activity with isotopic techniques (myocardial scintigraphy, positron emission tomography).

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