How to discriminate between hibernating and stunned myocardium.
OBJECTIVE
The aim of the present study was to examine if it is possible to discriminate between hibernating and stunned myocardium in vivo by determining the ratio between diastolic and systolic coronary arterial inflow and by measuring oxygen saturation in draining coronary venous blood.


METHODS
Experiments were performed in 32 open chest pigs anesthetized with sodium pentobarbital. In 11 pigs hibernation was induced in a part of the left ventricular myocardium by reducing flow in the mid-left anterior descending coronary artery (LAD) to about 60% of baseline flow. In 12 pigs stunning was induced by occluding mid-LAD twice for 10 min with a 30 min interval. In 9 pigs (control group) coronary flow was not manipulated.


RESULTS
We found, at comparable degrees of regional dysfunction, that the ratio between diastolic and systolic flow in stunned myocardium remained unaltered, but fell from about 2 to 1 in hibernating myocardium. Furthermore, coronary venous oxygen saturation decreased from about 30% to 17% in blood draining hibernating myocardium, but remained statistically unaltered in blood draining stunned myocardium.


CONCLUSIONS
We conclude that it is possible to discriminate between hibernating and stunned myocardium by measuring phasic coronary arterial blood flow and oxygen saturation in blood draining the region in question. During hibernation only, the diastolic flow component of coronary arterial inflow is reduced and the coronary venous oxygen extraction increased.
Grund
F
F
Institute for Experimental Medical Research, Ullevål University Hospital, Oslo, Norway.
Treiman
C
C
Ilebekk
A
A
D000704:Analysis of Variance; D000818:Animals; D001794:Blood Pressure; D003326:Coronary Circulation; D004195:Disease Models, Animal; D005260:Female; D006339:Heart Rate; D008297:Male; D009200:Myocardial Contraction; D017682:Myocardial Stunning / Q000473:pathology* / Q000503:physiopathology*; D010101:Oxygen Consumption; D013318:Stroke Volume; D013552:Swine