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Postischemic Myocardial "Stunning": A Clinically Relevant Phenomenon
- BHARAT PATEL, M.D.;
- ROBERT A. KLONER, M.D., Ph.D.;
- KARIN PRZYKLENK, Ph.D.; and
- EUGENE BRAUNWALD, M.D.
- Wayne State University and Harper Hospital, Detroit, Michigan; and Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
Excerpt
Coronary artery reperfusion by means of thrombolytic therapy is rapidly emerging as a fundamental strategy in the management of patients with acute myocardial infarction. Although successful recanalization can be achieved in most patients receiving timely interventional therapy for evolving myocardial infarction, previous experimental studies have shown that reperfusion, despite limiting infarct size, does not lead to immediate full recovery in regional myocardial function. Instead, the return of contractility in tissue salvaged by reflow is delayed for hours, days, or weeks (1-5)—a phenomenon termed "stunned myocardium" (6).
Myocardial stunning has been extensively studied in several experimental models of both brief and
