Delineation of myocardial stunning and hibernation by positron emission tomography in advanced coronary artery disease

Am Heart J. 1996 Mar;131(3):440-50. doi: 10.1016/s0002-8703(96)90521-9.


With positron emission tomography, the resting flow abnormalities underlying reversible left ventricular dysfunction in 17 patients with chronic coronary artery disease were delineated. The level of flow in reversible dysfuncTional segments (i.e., those demonstrating improvement after revascularization) was markedly variable, ranging from 0.32 to 1.25 ml/gm/min. In 20 of these segments, flow was preserved, whereas in 12 segments, flow was reduced, when compared with that in, age-matched controls. Preservation of flow was associated with preservation of myocardial oxygen consumption and no alterations in myocardial substrate use. In contrast, a reduction in flow resulted in a decrease myocardial oxygen consumption and an increase in myocardial glucose use. Thus resting reversible left ventricular dysfunction in patients with chronic coronary artery disease can reflect a diversity of resting flow abnormalities. Moreover, myocardial perfusion at rest is frequently within normal limits, suggesting that the reversible mechanical dysfunction in these patients is attributable to intermittent myocardial stunning and not hibernation.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Chronic Disease
  • Coronary Disease / diagnostic imaging*
  • Coronary Disease / etiology
  • Coronary Disease / physiopathology
  • Coronary Disease / therapy
  • Female
  • Glucose / metabolism
  • Humans
  • Male
  • Middle Aged
  • Myocardial Reperfusion
  • Myocardial Stunning / diagnostic imaging*
  • Myocardial Stunning / etiology
  • Myocardial Stunning / physiopathology
  • Myocardial Stunning / therapy
  • Myocardium / metabolism
  • Radionuclide Imaging
  • Ventricular Dysfunction, Left / diagnostic imaging*
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / therapy


  • Glucose