Stunning, Hibernation, and Preconditioning: Clinical Pathophysiology of Myocardial Ischemia

This monograph aims to summarize and integrate knowledge regarding the intrinsic adaptive mechanisms of the heart triggered by ischemia. The contributors review the initial adaptation to ischemia and the concept of preconditioning. Close attention is given to knowledge of myocardial stunning, including the role of calcium homeostasis and oxyradicals as well as the clinical impact and pharmacological modulation of myocardial stunning. Myocardial hibernation and its link with myocardial stunning are also discussed. The contributors attempt to integrate experimental data and clinical observations. The understanding of the basic pathophysiological mechanisms of these ischemic syndromes should help readers to correctly identify and treat patients with chronic ischemic left ventricular dysfunction.