Skip to main content
Log in

Is stunned myocardium ischemic on a microvascular level?

  • Focussed Issue: Myocardial Stunning
  • Coronary Blood Flow Alterations
  • Published:
Basic Research in Cardiology Aims and scope Submit manuscript

Conclusions

Stunned myocardium generally has normal resting flow and most studies have documented normal flow reserve. “Vascular stunning” (reduced vasodilator capacity) can be produced by ischemia, but the duration required is longer than that required to produce mechanical stunning. The two phenomenon can therefore be dissociated and are essentially unrelated. Nevertheless, despite evidence of normal microvascular patency in stunned myocardium, there are observations consistent with the existence of microvascular foci of ischemia, possibly related to vascular spasm or constriction, and this may explain the finding that increased flow in stunned myocardium may partially, or even largely, reverse the mechanical dysfunction. The “microvascular spasm” hypothesis may explain a significant portion of the dysfunction of stunned myocardium and deserves further study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hori M, Inoue M, Kitakaze M, Koretsune Y, Iwai K, Tamai J, Ito H, Kitabakate A, Sato T, Kamada T (1986) Role of adenosine in hyperemic response of coronary blood flow in microembolization. Amer J Physiol 250: H509-H518

    Google Scholar 

  2. Bolli R (1990) Mechanism of myocardial “stunning”. Circulation 82: 723–738

    Google Scholar 

  3. Nicklas JM, Gips S (1989) Decreased coronary flow reserve after transient myocardial ischemia in dogs. J Am Coll Cardiol 13: 195–199

    Google Scholar 

  4. Bolli R, Triana JF, Jeroudi MO (1990) Prolonged impairment of coronary vasodilation after reversible ischemia. Evidence for microvascular “stunning”. Circ Res 67: 332–343

    Google Scholar 

  5. Jeremy RW, Stahl L, Gillinov M, Litt M, Aversano TR, Becker LC (1989) Preservation of coronary flow reserve in stunned myocardium. Am J Physiol 256: H1301-H1310

    Google Scholar 

  6. Duncker DJ, McFalls EO, Krams R, Verdouw PD (1992) Pressure-maximal coronary flow relationship in regionally stunned porcine myocardium. Am J Physiol 262: H1744-H1751

    Google Scholar 

  7. McFalls EO, Duncker DJ, Krams R, Ward H, Gornick C, Verdouw PD (1991) Endothelium dependent vasodilatation following brief ischemia and reperfusion in anaesthetized swine. Cardiovasc Res 25: 659–665

    Google Scholar 

  8. Stahl LD, Weiss HR, Becker LC (1988) Myocardial oxygen consumption, oxygen supply/demand heterogeneity and microvascular patency in regionally stunned myocardium. Circulation 77: 865–872

    Google Scholar 

  9. Jeremy RW, Becker LC (1989) Neutrophil depletion does not prevent myocardial dysfunction after brief coronary occlusion. J Am Coll Cardiol 13: 1155–1163

    Google Scholar 

  10. Juneau CF, Ito BR, del Balzo U, Engler RL (1993) Severe neutrophil depletion by leucocyte filters or cytotoxic drug does not improve recovery of contractile function in stunned porcine myocardium. Cardiovasc Res 27: 720–727

    Google Scholar 

  11. Stahl LD, Aversano TR, Becker LC (1986) Selective enhancement of function of stunned myocardium by increased flow. Circulation 74: 843–851

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Becker, L.C. Is stunned myocardium ischemic on a microvascular level?. Basic Res Cardiol 90, 282–284 (1995). https://doi.org/10.1007/BF00797900

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00797900

Key words

Navigation