Commentary on hibernating myocardium and its clinical relevance

Conclusion

The discovery by Rahimtoola that chronic left ventricular regional dysfunction due to prolonged hypoperfusion can recover after full reperfusion has radically changed the current physiopathological concept of myocardial ischaemia and the actual treatment of CAD patients. We need, however, proper studies aimed to evaluate the role of the different diagnostic metodologies for detection of myocardial hibernation and to assess the clinical efficacy of revascularization of hibernating myocardium in terms of reduction of morbidity and mortality. From the clinical point of view attention and resorces should be concentrated on those case with large extension of hibernating myocardium, in which the differentiation of viable from non-viable myocardium and the stratification of operative risk is the real overriding clinical concern. It is this subset of patients which will justify further investigation in this fascinating field and which hopefully, will improve our therapeutical possibility.