Hibernating myocardium: a hypometabolic state for energy conservation

Moderately hypoperfused myocardium in animals initiates an active process that transiently reduces regional energy consumption below that required by the reduced flow. This eliminates most metabolic abnormalities of ischemia despite ongoing hypoperfusion. These interesting early metabolic adaptations help to confirm the concept of hibernating myocardium, a hypometabolic state for energy conservation. A similar metabolic response probably can occur in human myocardium. However, the complexities of coronary disease may make it difficult to demonstrate these metabolic adaptations in chronically hypofunctioning myocardium in humans.