title: Revascularization of hibernating myocardium: rate of metabolic and functional recovery and occurrence of oxidative stress.
abstract: BACKGROUND
  Left ventricular (LV) dysfunction due to coronary artery disease (CAD) may improve after revascularization in patients with hibernating myocardium (HM).
  
  
  RESULTS
  We compared the rate of metabolic (arterial-great cardiac vein differences of lactate, glucose and pyruvate) and functional (intra-operative transesophageal and epicardial echocardiography) recovery and occurrence of oxidative stress (myocardial release of oxidized glutathione (GSSG)) early after surgical revascularization, in patients with CAD, LV dysfunction and HM (n=16) vs those with preserved LV function (n=15). By comparing the two groups, we observed that, after de-clamping, in patients with HM (a) the kinetic of lactate production was converted to extraction (P<0.01 at 1, 5, 10 and 20 min after revascularization), (b) myocardial extraction of pyruvate increased (P<0.01 during the first 5 min after revascularization), (c) GSSG release was less and of shorter duration (P<0.01 at all times), (d) segmental wall motion score improved from 2.4+/-0.3 to 1.7+/-0.5 (P<0.01) as did the thickening of the akinetic territories corresponding to the antero-distal septum and to the distal anterior wall regions (to 36+/-23%, and to 36+/-13%, respectively). There was a correlation between the rate of recovery of metabolic and functional indices.
  
  
  CONCLUSIONS
  The contractile and metabolic recovery of HM is more rapid than that of non-HM, and it is not accompanied by oxidative stress.
authors.affiliation: Cardiovascular Pathophysiology Research Center, Salvatore Maugeri Foundation, University of Ferrara, Via Pinidolo 23, 25064 Gussago, Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ceconi
authors.forename: G
authors.initials: G
authors.lastname: La Canna
authors.forename: O
authors.initials: O
authors.lastname: Alfieri
authors.forename: A
authors.initials: A
authors.lastname: Cargnoni
authors.forename: G
authors.initials: G
authors.lastname: Coletti
authors.forename: S
authors.initials: S
authors.lastname: Curello
authors.forename: M
authors.initials: M
authors.lastname: Zogno
authors.forename: G
authors.initials: G
authors.lastname: Parrinello
authors.forename: S H
authors.initials: SH
authors.lastname: Rahimtoola
authors.forename: R
authors.initials: R
authors.lastname: Ferrari
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003402:Creatine Kinase / Q000097:blood; D004452:Echocardiography / Q000379:methods; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D009204:Myocardial Revascularization / Q000379:methods*; D017682:Myocardial Stunning / Q000378:metabolism / Q000601:surgery*; D018384:Oxidative Stress; D019289:Pyruvic Acid / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D007773:Lactates; D019289:Pyruvic Acid; D003402:Creatine Kinase