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@article{Gunning:1998,
author = {Gunning, MG and Kaprielian, RR and Pepper, J and Pennell, DJ and Fox, K and Sheppard, MN and Severs, NJ and Underwood, SR},
journal = {Heart},
title = {Histology of hibernating myocardium characterised by Tl-201 imaging and dobutamine cine MRI},
volume = {79},
year = {1998}
}

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TY  - JOUR
AB  - Aim: To characterise the histology of hibernating myocardium based on pre-operative imaging features and post-operative functional recovery. Methods: We studied 21 patients with impaired left ventricular function scheduled for CABG. All underwent stress and separate day rest Tl-201 scintigraphy, and low-dose dobutamine MRI pre-operatively. At CABG transmural biopsies were taken from up to 4 myocardial segments per patient. Follow-up rest MRI was conducted after 3-6 months. Significantly hypocontractile segments of myocardium (on pre-op MRI) were evaluated for response to dobutamine, reversible ischaemia, rest Tl-201 uptake and functional recovery. Segments were classified as hibernating if wall motion improved by ≥1 grade following CABG. Biopsy specimens were assessed for % connective tissue content(CT), degree of glycogen accumulation(GLY), and degree of myocyte loss(ML). Results: Comparing hibernating and non-hibernating segments(scar), mean CT was 29.3±15.8% vs 38.1±23.7%(p=ns), mean GLY was 1.1±1 vs 1.5±0.9(p=ns), and mean ML was 1.4±1.2 vs 1.2±0.9(p=ns) respectively. On pre-operative MRI, comparing segments which responded to dobutamine to those that did not, CT was 23.1±7.2 vs 35.3±21.3%(p<0.05), GLY was 1.2±0.8 vs 1.2±1(p=ns) and ML was 1.7±1 vs 1.3±1.1(p=ns) respectively. For segments with Tl-201 uptake ≥60% vs uptake <60%, CT was 28.4±16 vs 36.4±22.7%(p=ns). Comparing ischaemic vs non-ischaemic segments CT was 30.8±18.1 vs 32.1±19.7%, GLY was 1.1±1 vs 1.3±1.1(p=ns), and ML was 1.4±1.2 vs 1.2±1.1(p=ns) respectively. Conclusions: Regions of myocardium displaying inotropic repense to dobutamine contain significantly less fibrous tissue than non-responsive regions. Hibernating myocardium contains less fibrous tissue than scar but the difference is not significant. Glycogen accumulation and myocyte loss do not de
AU  - Gunning,MG
AU  - Kaprielian,RR
AU  - Pepper,J
AU  - Pennell,DJ
AU  - Fox,K
AU  - Sheppard,MN
AU  - Severs,NJ
AU  - Underwood,SR
PY  - 1998///
SN  - 1355-6037
TI  - Histology of hibernating myocardium characterised by Tl-201 imaging and dobutamine cine MRI
T2  - Heart
VL  - 79
ER  -

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