Author + information
- Received December 7, 1995
- Revision received March 11, 1996
- Accepted March 12, 1996
- Published online August 1, 1996.
- William F. Armstrong, MD, FACC*
- ↵*Address for correspondence: Dr. William F. Armstrong, University of Michigan Hospital, Division of Cardiology, 9D Room 9800, 1500 East Medical Center Drive, Ann Arbor, Michigan 48109-0119.
Chronic ischemic dysfunction of the left ventricle is commonly presumed to represent “hibernating” myocardium. The implication of this assumption is that with successful reperfusion, systolic function will improve. Several diagnostic techniques including dobutamine stress echocardiography have been used to detect “viable” myocardium in the setting of chronic left ventricular dysfunction. Predictive accuracies of 70% to 85% have been reported for identifying myocardium that recovers function. Recovery of function has been variable and often dependent on the severity of dysfunction. All current models have presumed that chronically dysfunctioning myocardium is “hibernating.” Obviously, in the chronic setting, dysfunction may have many causes and include components of transmural and nontransmural infarction as well as hibernating myocardium. This review focuses on the independent role that nontransmural infarction may play in chronic dysfunction and suggests its impact on diagnostic techniques used to identify hibernating myocardium.
- Received December 7, 1995.
- Revision received March 11, 1996.
- Accepted March 12, 1996.
- American College of Cardiology