title: Low cardiac output as physiological phenomenon in hibernating, free-ranging Scandinavian brown bears (Ursus arctos) - an observational study.
abstract: BACKGROUND
  Despite 5-7 months of physical inactivity during hibernation, brown bears (Ursus arctos) are able to cope with physiological conditions that would be detrimental to humans. During hibernation, the tissue metabolic demands fall to 25% of the active state. Our objective was to assess cardiac function associated with metabolic depression in the hibernating vs. active states in free-ranging Scandinavian brown bears.
  
  
  METHODS
  We performed echocardiography on seven free-ranging brown bears in Dalarna, Sweden, anesthetized with medetomidine-zolazepam-tiletamine-ketamine during winter hibernation in February 2013 and with medetomidine-zolazepam-tiletamine during active state in June 2013. We measured cardiac output noninvasively using estimates of hemodynamics obtained by pulsed wave Doppler echocardiography and 2D imaging. Comparisons were made using paired T-tests.
  
  
  RESULTS
  During hibernation, all hemodynamic indices were significantly decreased (hibernating vs. active state): mean heart rate was 26.0 (standard deviation (SD): 5.6) beats per min vs. 75.0 (SD: 17.1) per min (P=0.002), mean stroke volume 32.3 (SD: 5.2) ml vs. 47.1 (SD: 7.9) ml (P=0.008), mean cardiac output 0.86 (SD: 0.31) l/min vs. 3.54 (SD: 1.04) l/min (P=0.003), and mean cardiac index 0.63 (SD: 0.21) l/min/kg vs. 2.45 (SD: 0.52) l/min/ m2 (P<0.001). Spontaneous echo contrast was present in all cardiac chambers in all seven bears during hibernation, despite the absence of atrial arrhythmias and valvular disease.
  
  
  CONCLUSIONS
  Free-ranging brown bears demonstrate hemodynamics comparable to humans during active state, whereas during hibernation, we documented extremely low-flow hemodynamics. Understanding these physiological changes in bears may help to gain insight into the mechanisms of cardiogenic shock and heart failure in humans.
authors.affiliation: Department of Cardiology, University of Copenhagen, Gentofte Hospital, Copenhagen, Denmark. petergodsk@gmail.com.
authors.forename: Peter Godsk
authors.initials: PG
authors.lastname: Jørgensen
authors.forename: Jon
authors.initials: J
authors.lastname: Arnemo
authors.forename: Jon E
authors.initials: JE
authors.lastname: Swenson
authors.forename: Jan S
authors.initials: JS
authors.lastname: Jensen
authors.forename: Søren
authors.initials: S
authors.lastname: Galatius
authors.forename: Ole
authors.initials: O
authors.lastname: Frøbert
mesh_terms: D000064:Acclimatization / Q000502:physiology*; D000818:Animals; D001794:Blood Pressure / Q000502:physiology*; D002302:Cardiac Output / Q000502:physiology*; D006339:Heart Rate / Q000502:physiology*; D006605:Hibernation / Q000502:physiology*; D013548:Sweden; D001503:Ursidae / Q000502:physiology*