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16. What is meant by myocardial hibernation?
Areas of the myocardium that are persistently
underperfused, but still viable, may develop sustained
contractile dysfunction. This phenomenon is termed
as ‘myocardial hibernation’ (Fig. 4). It appears to
represent an adaptive response that may be associated
with depressed left ventricular function. This form
of dysfunction is reversible following coronary
revascularization. A related phenomenon, termed
‘myocardial stunning’, is the occurrence of persistent
contractile dysfunction following prolonged or repetitive
episodes of myocardial ischemia. Myocardial stunning
is often seen after reperfusion of acute myocardial
infarction. The essential difference in myocardial blood
flow is normal or near normal in myocardial stunning,
and it is reduced in hibernating myocardium.

Fig. 4: Myocardial hibernation