Functional recovery of hibernating myocardium after coronary bypass surgery: Does it coincide with improvement in perfusion?

Levosimendan for Weaning from Cardiopulmonary Bypass after Coronary Artery Bypass Grafting

“…This phenomenon has been observed after CABG and may improve with inotropic therapy. [11][12][13] New inotropic agents such as levosimendan are being introduced into clinical use. Levosimendan sensitizes troponin C to calcium, thus increasing the effects of calcium on cardiac myofilaments during systole.…”

Distribution of calcium in a subset of chronic hibernating myocardium in man

“…More recent analysis of the patients' data with 'hibernating' myocardium, however, showed that the depressed contractile state is not immediately reversed in a significant number of the patients, but a delayed recovery of function upon restoration of blood flow was seen instead (Tillisch et a]., 1986;Schelbert, 1991;Takeishi et al, 1991;Kloner & Przyklenk, 1991;Ross, 1991). A more in-depth study looking for possible causes to clarify this enigma and, in particular, the search for possible structural correlate(s) of such a delayed response is therefore highly warranted.…”

“…At the most recent symposium on myocardial viability during the annual sessions of the American College of Cardiology, Rahimtoola pointed out that hibernating myocardium is not a single entity of cardiac dysfunction but consists of subsets with different underlying pathologies, which may be held responsible for the fact that after revascularization the functional recovery is rapid, slow or very slow. In the present work, we refer to the subset 'chronic hibernation' in which it is presumed that functional recovery after restoration of blood flow occurs slowly, in contrast to 'acute hibernation' in which immediate recovery of function is observed (Takeishi et al, 1991;Kloner & Przyklenk, 1991;Ross, 1991;Rahimtoola, personal communication). The structural 0018-2214 9 1993 Chapman & Hall changes seen in 'chronic hibernation' (asynergic but noninfarcted segments) consist of a typical adaptive cellular remodelling which can be well appreciated with light microscopy, especially if the tissues are stained with a polychrome or a PAS (periodic acid-Schiff) stain Borgers & Flameng, in press).…”

I Diretriz da Sociedade Brasileira de Cardiologia Sobre Cardiologia Nuclear

“…Também foi amplamente demonstrada a recuperação da motilidade ventricular após as técnicas de revascularização mecânica e cirúrgica 43,[70][71][72][73] . As indicações para a avaliação terapêutica da DAC com os graus de recomendações e níveis de evidências, encontram-se na tabela III.…”