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European Heart Journal 1997 18(Supplement A):2-7; doi:10.1093/eurheartj/18.suppl_A.2
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Myocardial hibernation

A form of endogenous protection?

D. J. Hearse

Cardiovascular Research, The Rayne Institute, St Thomas' Hospital London, U.K.

Correspondence: D. J. Hearse, Cardiovascular Research, The Rayne Institute. St Thomas Hospital, London SE1 7EH

The origins and mechanisms of myocardial hibernation are obscure and controversial. Indeed, there is even debate over whether the hibernating heart is ‘ischaemic’. In attempting to clarify this last point, it is clear that there is no universally agreed definition of ischaemia. It is proposed that much of the confusion can be resolved distinguishing between biochemical and physiological ischaemia and ascertaining whether the tissue metabolism is in steady state equilibrium or is progressively deteriorating. On the basis of this, the hibernating heart would be designated as physiologically ischaemic but it would not exhibit the characteristics of biochemical ischaernia. This distinction also allows one to argue that hibernation is an adaptive phenomenon in which cardiac metabolism and function are down-regulated to match the available energy supply (perfusion-contraction matching). Such an adaptive response would be expected to avoid the occurrence of tissue injury but it would not be expected to prevent the occurrence of adaptive morphological changes that always occur with prolonged inactivity of muscle. However, the morphological characteristics of hibernation are controversial and, like so many other aspects of the hibernation controversy, the problem may not be resolved until an acceptable animal model of hibernation has been developed.

Key Words: Hibernation • ischaemia • reperfusion • perfusion-contraction matching • animals models • adaptive changes


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