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Echocardiographic Recognition of Myocardial Viability

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Stress Echocardiography

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Abstract

When facing dangerous environmental situations, most animal species react with a sympathoadrenergic fight or flight activation; others, such as the opossum, react with a vagal sympathoinhibitory discharge, or playing dead reaction, which discourages possible predators. The myocardium reacts to dangerous situations with opossum-like behavior. In several altered myocardial states (ischemia, hibernation, stunning), when the local supply-demand balance of the cell is critically endangered, the cell minimizes expenditure of energy used for development of contractile force, accounting at rest for about 60% of the high-energy phosphates produced by cell metabolism, and utilizes whatever is left for the maintenance of cellular integrity [1]. The echocardiographic counterpart of this cellular strategic choice is the regional asynergy of viable segments. Both viable and necrotic segments show a depressed resting function [2], but the segmental dysfunction of viable regions can be transiently normalized by proper inotropic stimulus (Fig.3 of Chap. 4).

Oppressed nature sleeps.

W. Shakespeare, King Lear, Act 3, Scene VI

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Authors and Affiliations

  1. Institute of Clinical Physiology, National Research Council, Via Moruzzi, 1, 56124, Pisa, Italy

    Eugenio Picano MD, PhD, FESC (Senior Medical Researcher of Italian National Research Council, Director, Echocardiography and Stress Testing Lab Institute of Clinical Physiology, Pisa, Scientific Director Cardiology, Clinica Cardiologica Montevergine, Mercogliano, Avellino, Editor-in-Chief Biomed Central Netjournal Cardiovascular Ultrasound)

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  1. Eugenio Picano MD, PhD, FESC
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© 2003 Springer-Verlag Berlin Heidelberg

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Picano, E. (2003). Echocardiographic Recognition of Myocardial Viability. In: Stress Echocardiography. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05096-5_19

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  • DOI: https://doi.org/10.1007/978-3-662-05096-5_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-05098-9

  • Online ISBN: 978-3-662-05096-5

  • eBook Packages: Springer Book Archive

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