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Abstract
Summary and Conclusion
The long term consequence of coronary artery disease (CAD) remains a chronic clinical problem, particularly with new therapeutic strategies that reduce the mortality associated with acute coronary syndromes and so more patients suffer from the long term sequel of CAD, the identification of viable myocardium is an important clinical issue among patients who have CAD and LV systolic dysfunction
(Mickleborough et al., 1995).
The most common variable influencing short and long term outcome in patients with CAD is the status of LV function and so the ability to distinguish reversible from irreversible myocardial injury is of critical importance in the management of patients with both acute and chronic CAD syndromes (Luciani., et al 2001).
Revascularization procedures such as Coronary Artery Bypass Grafting (CABG) or Percutaneous Coronary Intervention (PCI) may improve sever regional and global systolic dysfunction, improve function capacity, improve symptoms of heart failure and long term survival compared with medical therapy or cardiac transplantation (Rankin et al., 1999) and so we must identify patients who will gain benefit from revascularization and offer revascularization procedures only to patients who are more likely to achieve an improved quality of life or prolonged survival (Thompson, et al., 1996).
An article published in 1978 by Diamond., et al presaged the concept of hibernating myocardium; reports of sometimes dramatic improvement in segmental left ventricular function following coronary bypass surgery, although not universal, leave a clear implication that ischemic non infarcted myocardium can exist in a state of function hibernation. Rahimtoola in an article published in 1985, popularized this concept and later suggested that hibernating myocardium is a state of persistently impaired myocardial and left ventricular function at rest due to reduced coronary blood flow that can be partially or completely restored to normal either improving blood flow or by reducing oxygen demand.