Identifying and Managing Hibernating Myocardium: What’s New and What Remains Unknown?
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Key result
While understanding of hibernation pathophysiology has improved dramatically, the clinical utility of identifying and targeting hibernation in ischemic heart failure remains unclear.
Population
Patients with ischaemic heart failure, with a specific focus on the role of hibernating myocardium in acute…
Design
Review
Authors
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Implication
Viability testing should not guide revascularization in acute decompensated HF; leaves open need for targeted prospective trials.
Structured PICO
P
Population
Patients with ischaemic heart failure, with a specific focus on the role of hibernating myocardium in acute decompensated heart failure (ADHF)
I
Intervention
Identification (via advanced imaging such as CMR, echocardiography, and cardiac catheterization) and management (revascularization) of hibernating myocardium
This review highlights that while advanced imaging can identify hibernating myocardium, the clinical utility of viability testing to guide revascularization, especially in acute decompensated heart failure, remains uncertain.
Limitations
- Research to date has exclusively involved patients with ambulatory heart failure, limiting extrapolation to acute decompensated heart failure.
- The role of viability tests in planning surgical revascularisation remains unclear.
Cite This Study
Ryan et al. (2018) conducted a review in Ischaemic heart failure and hibernating myocardium. Revascularization and viability testing vs. Medical therapy was evaluated. While understanding of hibernation pathophysiology has improved dramatically, the clinical utility of identifying and targeting hibernation in ischemic heart failure remains unclear.
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