Hibernation (myocardium)

Under myocardial hibernation (English literally for "hibernation") is defined as a pathophysiological state of the heart muscle that can occur in highly of reduced blood flow to the heart muscle - for example, in coronary artery disease . It is mainly characterized by a reduced pumping function of the poorly perfused muscle parts. As soon as the blood supply is restored, the pumping function of the heart muscle tissue quickly recovers.

Demarcation

The difference to the Stunning of the heart muscle is that with this the pumping function only recovers after a longer phase, while with hibernation this happens immediately. In both cases the cardiac output is reduced.

In myocardial infarction (heart attack), in contrast to stunning and hibernation, the loss of function of the affected parts of the heart muscle is irreversible (irreversible). These parts are replaced by scar tissue , and function is not restored even after the blood circulation has been restored.

In contrast to hibernation or freezing cold , which represent physiological processes and affect all life processes of the respective animal, with stunning and myocardial hibernation only the parts of the heart muscle affected by the reduced blood flow are impaired. Stunning and hibernation are natural processes, unlike artificially induced cardiac arrest (cardioplegia).

mechanism

The reduced sensitivity to calcium in the heart muscle cells is discussed as a possible mechanism of hibernation . If the hibernation lasts for a longer period of time, there is a microscopic increase in fibrosis and myofibril atrophy in the sense of a dedifferentiation of the muscle cells.

diagnosis

Since, with regard to mortality, only those patients with impaired pumping function of the heart as a result of a circulatory disorder benefit from a restoration of blood flow ( revascularization : coronary artery bypass or PTCA ), the distinction between dead and hibernating myocardial tissue is of outstanding importance. For this purpose, especially coming myocardial scintigraphy in SPECT technique with ²⁰¹ Tl thallium (I) chloride and the positron emission tomography (PET) using ¹⁸ F-2-deoxy-2-fluoro-D-glucose (FDG) for use .

Individual evidence

1. ↑ H. Dörge, R. Schulz, G. Heusch: Pathophysiology of Hibernation, Stunning and Ischemic Preconditioning. In: The internist. 39, 1998, p. 676, doi: 10.1007 / s001080050230 .
2. ↑ Oliver Lindner: Myocardial Perfusion Scintigraphy - A Guide for Practice. Uni-Med, Bremen 2010. ISBN 978-3-8374-1224-6 Chapter Vitality Diagnostics , pp. 30–33.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !