Echocardiographic Recognition of Myocardial Viability

  • Eugenio Picano


When facing dangerous environmental situations, most animal species react with a sympathoadrenergic fight or flight activation; others, such as the opossum, react with a vagal sympathoinhibitory discharge, or playing dead reaction, which discourages possible predators. The myocardium reacts to dangerous situations with opossum-like behavior. In several altered myocardial states (ischemia, hibernation, stunning), when the local supply-demand balance of the cell is critically endangered, the cell minimizes expenditure of energy used for development of contractile force, accounting at rest for about 60% of the high-energy phosphates produced by cell metabolism, and utilizes whatever is left for the maintenance of cellular integrity [1]. The echocardiographic counterpart of this cellular strategic choice is the regional asynergy of viable segments. Both viable and necrotic segments show a depressed resting function [2], but the segmental dysfunction of viable regions can be transiently normalized by proper inotropic stimulus (Fig.3 of Chap. 4).


Myocardial Viability Stress Echocardiography Dobutamine Stress Dobutamine Stress Echocardiography Stun Myocardium 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Eugenio Picano
    • 1
  1. 1.Institute of Clinical PhysiologyNational Research CouncilPisaItaly

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