New Paradigms of Coronary Artery Disease Hibernation, Stunning, Ischemic Preconditioning

Myocardial Hibernation.- I. Short-term hibernation: evidence for downregulation of contractile function and metabolic adaptation.- Critical role of energy supply and glycolysis during short-term hibernation.- Hibernating myocardium represents a primary downregulation of regional myocardial oxygen consumption distal to a critical coronary stenosis.- Myocardial hibernation: relationship to a model for segmental dyskinesis.- Myocardial hibernation in terms of the flow- function relationship.- Contractile pattern in acutely hibernating myocardium.- Excitation-contraction coupling in hibernating myocardium.- Hibernating myocardium: a hypometabolic state for energy conservation.- Myocardial hibernation.- Acute adaptation to ischemia: Short-term hibernating myocardium.- II. Long-term hibernation.- Myocardial hibernation: unresolved physiological and clinical issues.- Hibernating myocardium.- Hibernating myocardium: a brief article.- Myocardial hibernation, stunning, or both?.- Structural aspects of the chronic hibernating myocardium in man.- Hibernating myocardium: adaptation or degeneration?.- The hibernating myocardium: identification of viable myocardium in patients with coronary artery disease and chronic left ventricular dysfunction.- Commentary on hibernating myocardium and its clinical relevance.- Hibernating myocardium, a clinical entity.- Identification of "hibernating myocardium" by imaging approaches.- Myocardial Stunning.- I. Definition and occurence.- Ubiquity of myocardial stunning.- II. Methodological and conceptual problems.- Common methodological problems and artifacts associated with studies of myocardial stunning in vivo.- Stunning: Three questions and concerns.- III. Excitation-contraction coupling.- Do ATP-sensitive potassium channels play a role in myocardial stunning?.- Stunned myocardium: a disease of the myofilaments?.- Stunned myocardium, an opinionated review.- IV. Metabolism.- Myocardial stunning: the role of oxidative substrate metabolism.- Adjustments in competitive substrate utilization in stunned myocardium during early reperfusion.- V. Coronary blood flow alterations.- Is stunned myocardium ischemic on a microvascular level?.- Absolute myocardial blood flow in chronic left ventricular dysfunction.- Coronary vasomotion of the stunned myocardium.- VI. Pharmacotherapy.- Therapy for myocardial stunning.- Stunned myocardium: inotropic reserve and pharmacological attenuation.- VII. Clinical relevance: hibernation vs. stunning.- The elusive difference between hibernation and stunning in patients.- Commentary on myocardial stunning and its clinical relevance.- Chronic stunning: The new switch in thought.- Ischemic Preconditioning.- I. Ischemic preconditioning: the concept.- Ischemic preconditioning: a brief review.- Preconditioning - a reappraisal of protection.- Ischemic preconditioning, remembrances of things past and future.- Three questions about preconditioning.- II. Triggers and mediators of ischemic preconditioning: adenosine, bradykinin, nitric oxide and KATP-channels.- Preconditioning-induced protection against post-ischemic contractile dysfunction: Inhibitory effect of tissue washout.- Adenosine and bradykinin: Are they independent triggers of precondi--tioning?.- Activation of Ecto-5?-nucleotidase and cardioprotection by ischemic preconditioning.- Endothelial cells, nitric oxide and ischaemic preconditioning.- Criteria for a mediator or effector of myocardial preconditioning: Do KATP channels meet the requirements?.- III. The controversial role of protein kinase C in ischemic preconditioning.- Preconditioning: Markers vs. epiphenomena.- Limitation of infarct size by myocardial ischemic preconditioning.- Role of protein kinase C in ischemic preconditioning: in search of the "pure and simple truth".- IV. Trigger mechanisms other than ischemia: stress and stretch.- Cardioprotection by organs in stress or distress.- An alternative perspective on ischemic preconditioning derived from mathematical modeling.- V. Ischemic preconditioning vs. myocardial hibernation.- Ischemic preconditioning and myocardial hibernation: Is there a common mechanism?.- VI. Second window of protection.- Delayed myocardial protection following ischaemic preconditioning.- The early and late phases of preconditioning against myocardial stunning and the essential role of oxyradicals in the late phase: an overview.