Myocardial stunning

Myocardial stunning
Other namestransient post-ischemic myocardial dysfunction[1]
SpecialtyCardiology Edit this on Wikidata
ComplicationsTakotsubo cardiomyopathy
Differential diagnosishibernating myocardium, silent ischemia, myocardial infarction, acute pericarditis, myocarditis, pulmonary embolism

Myocardial stunning or transient post-ischemic myocardial dysfunction is a state of mechanical cardiac dysfunction that can occur in a portion of myocardium without necrosis after a brief interruption in perfusion, despite the timely restoration of normal coronary blood flow.[2][3] In this situation, even after ischemia has been relieved (by for instance angioplasty or coronary artery bypass surgery) and myocardial blood flow (MBF) returns to normal, myocardial function is still depressed for a variable period of time, usually days to weeks.[2][1] This reversible reduction of function of heart contraction[4] after reperfusion is not accounted for by tissue damage or reduced blood flow, but rather, its thought to represent a perfusion-contraction "mismatch".[5][2] Myocardial stunning was first described in laboratory canine experiments in the 1970s where LV wall abnormalities were observed following coronary artery occlusion and subsequent reperfusion.[6]

  1. ^ a b Kloner R (2020). "Stunned and Hibernating Myocardium: Where are we nearly 4 decades later?". Journal of the American Heart Association. 9 (3): e015502. doi:10.1161/JAHA.119.015502. PMC 7033879. PMID 32013699.
  2. ^ a b c Bolli R (December 1992). "Myocardial 'stunning' in man". Circulation. 86 (6): 1671–1691. doi:10.1161/01.cir.86.6.1671. PMID 1451239.
  3. ^ Braunwald E (1982). "The stunned myocardium: prolonged, postischemic ventricular dysfunction". Circulation. 66 (6): 1146–1149. doi:10.1161/01.cir.66.6.1146. PMID 6754130. S2CID 6844410.
  4. ^ Myocardial+Stunning at the U.S. National Library of Medicine Medical Subject Headings (MeSH)
  5. ^ Grund F (February 2001). "Three cardiac mysteries--stunning, hibernation and ischemic preconditioning". Tidsskr. Nor. Laegeforen. (in Norwegian). 121 (4): 440–4. PMID 11255859.
  6. ^ Vaidya Y (August 2020). "Myocardial Stunning and Hibernation". StatPearls [Internet]. PMID 30725711.