Depressed recovery of subendocardial perfusion in persistent heart failure after complete revascularisation in diabetic patients with hibernating myocardium

Mizuno, R; Fujimoto, S; Saito, Y; Nakamura, S
May 2009
Heart;May2009, Vol. 95 Issue 10, p830
Academic Journal
Objectives: To investigate the relation between myocardial perfusion and heart failure (HF) status after revascularisation in patients with HF due to hibernating myocardium (HM) in diabetic and non-diabetic subjects. Methods: 31 diabetic and 33 non-diabetic subjects with HF due to HM, who were already scheduled for complete revascularisation, were studied. Before and after revascularisation, left ventricular function and regional perfusion in subendocardial and subepicardial portions of the left ventricular wall were evaluated. Results: Before revascularisation, left ventricular function and regional perfusion were similar in diabetic and non-diabetic subjects. At 6 months after revascularisation, subepicardial perfusion was markedly improved both in diabetic and non-diabetic subjects. However, subendocardial perfusion was markedly improved only in non-diabetic subjects and was little changed in diabetic patients. Thus, subendocardial perfusion was much lower in diabetic than non-diabetic subjects. Left ventricular function was improved more in non-diabetic than in diabetic subjects. Persistent HF was found much more often in diabetic than non-diabetic subjects. At multivariate analysis, subendocardial perfusion at 6 months independently contributed to persistent HF. Conclusions: This study describes the intramural heterogeneity of recovery of myocardial perfusion with depressed improvement in the subendocardial portion and its relation with persistent HF after complete revascularisation in diabetic patients with HF due to HM.


Related Articles

  • Radionuclide techniques for the assessment of myocardial viability and hibernation. Bax, J. J.; van der Wall, E. E.; Harbinson, M. // Heart;Aug2004 Supplement 5, Vol. 90, pv26 

    The article focuses on radionuclide techniques for the assessment of myochondrial viability and hibernation. Hibernation refers to a condition of chronic sustained abnormal contraction caused by chronic underperfusion in patients with coronary artery disease in whom revascularisation causes...

  • Evaluation of hibernating myocardium. Bax, J. J.; Poldermans, D.; van der Wall, E. E. // Heart;Nov2004, Vol. 90 Issue 11, p1239 

    The article discusses myocardial hibernation. Over the years, physicians have popularized the term hibernation to describe the situation of chronic obstructive coronary artery disease resulting in chronic contractile dysfunction, which could be reversed after surgical revascularisation. Chronic...

  • ELECTRONIC PAGES: Heart Online reports: www.heartjnl.com.  // Heart;Jul2004, Vol. 90 Issue 7, p776 

    Myocardial hibernation is recognized as chronic hypoperfusion of the myocardium and its functional recovery after surgical revascularisation has been described. A case of surgery for complex lesions including severe aortic valve regurgitation, coronary ostial stenosis, and aortic calcification...

  • ALTERATION OF THE β ADRENERGIC SIGNALLING AXIS IN HIBERNATING MYOCARDIUM. John, A. S.; Depre, C.; Rimoidi, O. E.; Markiewicz, J.; Pepper, J. R.; Dreyfus, G. P.; Vatner, P. E.; Pennell, D. J.; Camici, P. G. // Heart;May2004 Supplement 2, Vol. 90, pA45 

    The article focuses on a study related to alteration of the β adrenergic signaling axis in hibernating myocardium (HM). Left Ventricle dysfunction in patients with CAD and hibernating myocardium may improve after revascularisation. The pashophysiology of dysfunction is incompletely...

  • Hibernating myocardium: pathophysiology, diagnosis, and treatment. Slezak, Jan; Tribulova, Narcis; Okruhlicova, Ludmila; Dhingra, Rimpy; Bajaj, Anju; Freed, Darren; Singal, Pawan // Canadian Journal of Physiology & Pharmacology;Apr2009, Vol. 87 Issue 4, p252 

    Comprehensive management of patients with chronic ischemic disease is a critically important component of clinical practice. Cardiac myocytes have the potential to adapt to limited flow conditions by adjusting contractile function, reducing metabolism, conserving resources, and preserving...

  • Carvedilol improves myocardial contractility compared with metoprolol in patients with chronic hibernating myocardium after revascularization. Schwarz, Ernst R.; Gupta, Rajiv; Tu Phuong Diep; Nowak, Bernd; Kostin, Sawa; Grohmann, Beate; Uretsky, Barry F.; Schaper, Jutta; Diep, Tu Phuong // Journal of Cardiovascular Pharmacology & Therapeutics;Sep2005, Vol. 10 Issue 3, p181 

    Background: We tested the hypothesis of whether carvedilol delays morphologic degeneration and improves functional outcome compared with metoprolol tartrate in patients with hibernating myocardium undergoing surgical revascularization. We have previously shown that patients with...

  • CRT in Patients with Heart Failure: Time Course of Perfusion and Wall Motion Changes. Gimelli, Alessia; Frumento, Paolo; Valle, Guido; Stanislao, Mario; Startari, Umberto; Piacenti, Marcello; Marzullo, Paolo // Cardiology Research & Practice;Jan2010, p1 

    In patients treated with CRT no data relative to the relationship between regional wall motion and perfusion and reverse remodelling of the left ventricle at short and medium term followup were available. To this aim, 36 heart failure patients were studied by G-SPECT before (T0), within 2 months...

  • Prevalence of myocardial viability assessed by single photon emission computed tomography in patients with chronic ischaemic left ventricular dysfunction. Schinkel, A.F.L.; Bax, J.J.; Sozzi, F.B.; Boersma, E.; Valkema, R.; Elhendy, A.; Roelandt, J.R.T.C.; Poldermans, D. // Heart;Aug2002, Vol. 88 Issue 2, p125 

    Objective: To assess the prevalence of myocardial viability by technetium-99m (Tc-99m)-tetrofosmin/ fluorine-18-fluorodeoxyglucose (FDG) single photon emission computed tomography (SPECT) in patients with ischaemic cardiomyopathy. Design: A retrospective observational study. Setting:...

  • Coronary patency and its relation to contractile reserve in hibernating myocardium. Fallavollita, James A.; Logue, Michael; Canty Jr., John M. // Cardiovascular Research;Jul2002, Vol. 55 Issue 1, p131 

    Objectives: Recent clinical studies suggest that contractile reserve may occur in a minority of viable, chronically dysfunctional segments with reduced resting flow (hibernating myocardium). We hypothesized that epicardial artery patency might predict which segments have critically...


Read the Article


Sign out of this library

Other Topics