Key result
Myocardial blood flow remaining above 30% of baseline following a sudden reduction allows the myocardium to adapt to ischemia, remain viable, and recover metabolically.
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Design
Review
May refine viability thresholds in ischemic assessment; leaves open prospective outcome validation.
As long as myocardial blood flow, following a sudden reduction, remains above 30% of baseline, the myocardium can adapt to ischemia, i.e., recover metabolically, remain viable, and increase its contractile function during inotropic stimulation. This adaptive response to ischemia is termed "hibernation". The detailed mediators of such adaptation are unknown at present.
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Heusch et al. (1996) studied this question. Myocardial blood flow remaining above 30% of baseline following a sudden reduction allows the myocardium to adapt to ischemia, remain viable, and recover metabolically.
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