Current interpretation of myocardial stunning

Trends Cardiovasc Med. 2018 May;28(4):263-271. doi: 10.1016/j.tcm.2017.11.005. Epub 2017 Nov 27.

Abstract

Myocardial stunning is a temporary post-ischemic cardiac mechanical dysfunction. As such, it is a heterogeneous entity and different conditions can promote its occurrence. Transient coronary occlusion, increased production of catecholamines and endothelin, and myocardial inflammation are all possible causes of myocardial stunning. Possible underlying mechanisms include an oxyradical hypothesis, calcium overload, decreased responsiveness of myofilaments to calcium, and excitation-contraction uncoupling due to sarcoplasmic reticulum dysfunction. The aim of this review is to summarize the clinical conditions that may be responsible for stunned myocardium.

Keywords: Calcium overload; Catecholamines; Coronary reperfusion; Myocardial ischemia; Myocardial stunning; Oxyradicals.

Publication types

  • Review

MeSH terms

  • Animals
  • Calcium / metabolism
  • Catecholamines / metabolism
  • Endothelins / metabolism
  • Excitation Contraction Coupling
  • Humans
  • Inflammation Mediators / metabolism
  • Myocardial Contraction*
  • Myocardial Stunning / diagnosis
  • Myocardial Stunning / etiology*
  • Myocardial Stunning / metabolism
  • Myocardial Stunning / physiopathology
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Myofibrils / metabolism*
  • Myofibrils / pathology
  • Reactive Oxygen Species / metabolism
  • Risk Factors
  • Sarcoplasmic Reticulum / metabolism*
  • Sarcoplasmic Reticulum / pathology

Substances

  • Catecholamines
  • Endothelins
  • Inflammation Mediators
  • Reactive Oxygen Species
  • Calcium