The Recovery of Hibernating Hearts Lies on a Spectrum: from Bears in Nature to Patients with Coronary Artery Disease

J Cardiovasc Transl Res. 2015 Jun;8(4):244-52. doi: 10.1007/s12265-015-9625-5. Epub 2015 May 7.


Clinicians often use the term "hibernating myocardium" in reference to patients with ischemic heart disease and decreased function within viable myocardial regions. Because the term is a descriptor of nature's process of torpor, we provide a comparison of the adaptations observed in both conditions. In nature, hearts from hibernating animals undergo a shift in substrate preference in favor of fatty acids, while preserving glucose uptake and glycogen. Expression of electron transport chain proteins in mitochondria is decreased while antioxidant proteins including uncoupling protein-2 are increased. Similarly, hibernating hearts from patients have a comparable metabolic signature, with increased glucose uptake and glycogen accumulation and decreased oxygen consumption. In contrast to nature however, patients with hibernating hearts are at increased risk for arrhythmias, and contractility does not fully recover following revascularization. Clearly, additional interventions need to be advanced in patients with coronary artery disease and hibernating myocardium to prevent refractory heart failure.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Adaptation, Physiological
  • Animals
  • Antioxidants / metabolism
  • Arrhythmias, Cardiac / physiopathology
  • Biomarkers / metabolism
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / metabolism
  • Coronary Artery Disease / physiopathology*
  • Coronary Artery Disease / therapy
  • Energy Metabolism
  • Hibernation*
  • Humans
  • Myocardial Contraction
  • Myocardial Stunning / diagnosis
  • Myocardial Stunning / metabolism
  • Myocardial Stunning / physiopathology*
  • Myocardial Stunning / therapy
  • Myocardium / metabolism
  • Myocardium / pathology
  • Recovery of Function
  • Treatment Outcome
  • Ursidae / metabolism
  • Ursidae / physiology*


  • Antioxidants
  • Biomarkers