- Shopping Bag ( 0 items )
Stunning is potentially an important complication of myocardial reperfusion. In contrast, hibernation is an important complication of myocardial ischemia. This book presents different viewpoints on these subjects, taken from a series of peer-reviewed articles which first appeared in Cardiovascular Drugs and Therapy, and now in this book. In addition, a certain number of articles were directly invited for the book.
The introductory article is by Eugene Braunwald, who with Kloner introduced the term myocardial stunning in 1982. The experimental phenomenon had first been described by Heyndrickx et al. This important concept of stunning is examined from a number of points of view in a series of articles which clarify the experimental causes and the clinical implications. The section on hibernation is introduced by Tubau and Rahimtoola, the latter having first propounded the concept in 1989.
The difference between stunning and hibernation is that stunning is essentially a post-ischemic dysfunction of the myocardium, temporary in nature, occurring at a time when coronary blood flow is apparently normal or supranormal. Hibernation, on the other hand, is a condition of reduced contractile activity, the direct result of chronic ischemia and hence a sign of a tolerable reduction in blood flow. Possibly the reduction in contractile activity of the hibernating heart balances the reduction in the oxygen availability (the 'smart heart' of Rahimtoola). This non-contractile heart is hibernating, awaiting the return of summer after winter, and willing to contract normally again whenever warm coronary blood is restored.
It is certain that the concepts of stunning and hibernation are here to stay, that they have or will have clinical relevance, and that the search for the most appropriate diagnosis and therapy for each condition is now under way. Hence, a greater understanding of the experimental work which underlies these two conditions is highly appropriate.
1. Introduction; L.H. Opie. Stunning. 2. Stunning of the Myocardium: An Update; E. Braunwald. 3. Stunning: A Radical Re-view; D.J. Hearse. 4. Clinical Relevance of Myocardial 'Stunning'; R. Bolli, C.J. Hartley, R.S. Rabinovitz. 5. Pathogenetic Role for Calcium in Stunning; E. Marban. 6. Post Ischemic Stunning: The Case for Calcium as the Ultimate Culprit; L.H. Opie. 7. Role of Adenosine in the Treatment of Myocardial Stunning; M.B. Forman, C.E. Velasco. 8. Do Neutrophils Contribute to Myocardial Stunning? L.C. Becker. 9. Proclivity of Activated Neutrophils to Cause Postischemic Cardiac Dysfunction: Participation in Stunning? K. Mullane, R. Engler. 10. Molecular Mechanisms in 'Stunned' Myocardium; W. Schaper. 11. Preconditioning Myocardium with Ischemia; R.B. Jennings, C.E. Murry, K.A. Reimer. 12. Stunning: Damaging or Protective to the Myocardium? R. Ferrari, O. Visioli. 13. Calcium Antagonists and Stunned Myocardium: Importance for Clinicians? K. Przyklenk, R.A. Kloner. 14. Oxidative Metabolism in Reperfused Myocardium; R. Lerch. Hibernation. 15. Hibernating Myocardium: An Historical Perspective; J.F. Tubau, S.H. Rahimtoola. 16. Hibernation and Myocardial Ischemia: Clinical Detection by Positron Emission Tomography; N. Uren, P. Camici. 17. Recovery of Myocardial Function in the Hibernating Heart. Stunning and Hibernation: Contrasts and Comparisons. 18. Calcium, Calcium Antagonists, Stunning and Hibernation: An Overview; W.G. Nayler. 19. Recruitment of an Inotropic Reserve in Hibernating and Stunned Myocardium; G. Heusch, R. Schulz. 20. Myocardial Stunning and Hibernation: Mechanisms and Clinical Implications; R.A. Kloner, E. Braunwald. Index.