Skip to main content

Hibernation and Stunning of Arterial Myocytes: Clinical Reversal by EDTA Chelation Therapy

  • Chapter
  • 79 Accesses

Part of the NATO ASI Series book series (NSSA,volume 294)

Abstract

In recent years numerous reports have appeared demonstrating that even in the absence of previous myocardial infarction, patients with coronary artery disease often present with chronic regional wall motion abnormalities that are reversible spontaneously1 after coronary revascularization2, angioplasty3,4, thrombosis5, and chelation therapy.6 This regional dysfunction, in the absence of infarction, is postulated to result from either prolonged postischemic dysfunction (stunning) or adaptation to chronic hypoperfusion (hibernation). Hibernation myocardium has been defined as a state of persistently impaired left ventricular function at rest that is due to reduced coronary blood flow.7 In contrast, stunned myocardium is defined as postischemic left ventricular dysfunction.8,9 Myocardial stunning and hibernation have been reported to last for months to years.1,2,10,11,12 It has now been established that the time sequence for return of functional integrity to hibernating myocardial tissue can be independent of correcting the mechanical obstruction of flow.2,3,13,14,15 Stunned myocardial cells are postulated to be a temporary phenomenon and the term simply refers to the unexplained delay in return of optimal function of cellular activity after flow has been restored. Myocyte hibernation appears to be much more difficult to explain. All reports to date have involved myocardial myocytes.

Keywords

  • Chelation Therapy
  • Stun Myocardium
  • Impaired Left Ventricular Function
  • Anterior Infarction
  • Hibernation Myocardium

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-4899-0133-0_26
  • Chapter length: 3 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   149.00
Price excludes VAT (USA)
  • ISBN: 978-1-4899-0133-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   199.99
Price excludes VAT (USA)
Hardcover Book
USD   319.00
Price excludes VAT (USA)

References

  1. Galli M, Marcassa C, Bolli R, et al. Spontaneous delayed recovery of perfusion and contraction after the first 5 weeks after anterior infarction. Evidence for the presence of hibernating myocardium in the infarcted area. Circulation 1994; 90(3): 1386–1397.

    PubMed  CrossRef  CAS  Google Scholar 

  2. Takeishi Y, Tono-oka I, Kubota I, et al. Functional recovery of hibernating myocardium after coronary bypass surgery: Does it coincide with improvement in perfusion? Am Heart J 1991; 122(3 Pt 1):665–670.

    PubMed  CrossRef  CAS  Google Scholar 

  3. Swift PC, Turner JH, Oxer HF, et al. Myocardial hibernation identified by hyperbaric oxygen treatment and echocardiography in post-infarction patients: Comparison with exercise thallium scintigraphy. Am Heart J 1992; 124(5):1151–1158.

    PubMed  CrossRef  CAS  Google Scholar 

  4. de Feyter PJ, Surapranata H, Serruys PW, et al. Effects of successful percutaneous transluminal coronary angioplasty on global and regional left ventricular function in unstable angina pectoris. Am J Cardiol 1987; 60(13):993–997.

    PubMed  CrossRef  Google Scholar 

  5. Conti CR. The stunned and hibernating myocardium: A brief review. Clin Cardiol 1991; 14(9):708–712.

    PubMed  CrossRef  CAS  Google Scholar 

  6. Edwards DA, Crimm L, Davis PR. Noninvasive cardiology and chelation patients. AAMP Fall Convention, November 1985, San Francisco. Telebeam Audiotapes; Sherman Oaks, CA, 1986.

    Google Scholar 

  7. Rahimtoola SH. The hibernating myocardium. Am Heart J 1989; 117(1):211–221.

    PubMed  CrossRef  CAS  Google Scholar 

  8. Kloner RA, Przyklenk K, and Patel B. Altered myocardial states. The stunned and hibernating myocardium. Am J Med 1989; 9(1A):14–22.

    CrossRef  Google Scholar 

  9. Kloner RA and Przyklenk K. Hibernation and stunning of the myocardium. New Engl J Med 1992; 325(26): 1877–1879.

    CrossRef  Google Scholar 

  10. Buxton DB. Dysfunction in collateral-dependent myocardium. Hibernation or repetitive stunning? Circulation 1993; 87(5):1756–1758.

    PubMed  CrossRef  CAS  Google Scholar 

  11. Bashour TT and Mason DT. Myocardial hibernation and “embalmment.” Am Heart J 1990; 119(3 pt 1): 706–708.

    PubMed  CrossRef  CAS  Google Scholar 

  12. Ito H, Tomooka T, Sakai N, et al. Time course of functional improvement in stunned myocardium in risk area in patients with reperfused anterior infarction. Circulation 1993; 87(2):355–362.

    PubMed  CrossRef  CAS  Google Scholar 

  13. Bolli R. Mechanism of myocardial “stunning.” Circulation 1990; 82(3)723–738.

    PubMed  CrossRef  CAS  Google Scholar 

  14. Chiariello M, Perrone-Filardi P, and Ambrosio G. Hibernating and stunned myocardium. Cardioscience 1993;4(2):63–68.

    PubMed  CAS  Google Scholar 

  15. Vanoverschelde JL, Wijns W, Depre C, et al. Mechanisms of chronic regional postischemic dysfunction in humans. New insights from the study of noninfarcted collateral-dependent myocardium. Circulation 1993;87(5):1513–1523.

    PubMed  CrossRef  CAS  Google Scholar 

  16. Sadler TW. Langman’s Medical Embryology, 6th Edition 1990, Williams and Wilkins, Baltimore, pp. 71–73.

    Google Scholar 

  17. Moore KL. The developing human. Clinically Oriented Embryology, 4th Edition 1988, WB Saunders, Philadelphia, pp. 286–294.

    Google Scholar 

  18. Robbins SL, Cotran RS, and Kumar V. Pathologic Basis of Disease, 3rd Edition 1984, WB Saunders, Philadelphia, pp. 506–567.

    Google Scholar 

  19. Cranton EM and Frackelton JRP. Free radical pathology in age-associated diseases: Treatment with EDTA chelation, nutrition, and antioxidants. J Advancement Med 1989, 1/2:17–54.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 1998 Springer Science+Business Media New York

About this chapter

Cite this chapter

Edwards, D.A., Illarina, C.I. (1998). Hibernation and Stunning of Arterial Myocytes: Clinical Reversal by EDTA Chelation Therapy. In: Catravas, J.D., Callow, A.D., Ryan, U.S. (eds) Vascular Endothelium. NATO ASI Series, vol 294. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0133-0_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-0133-0_26

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-0135-4

  • Online ISBN: 978-1-4899-0133-0

  • eBook Packages: Springer Book Archive