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Prognosis of hibernating myocardium is independent of recovery of function: evidence from a routine based follow-up study.

Revascularization of hibernating segments improves both ventricular function (VF) and survival. In this study, we determined whether this relation is true in a routine based patients population with mildly reduced VF. Two to 6 years after undergoing 201Tl scintigraphy to detect hibernation, 153 patients were interviewed in order to collect medical information. This population was divided into four groups, according to the presence or absence of myocardial hibernation and of revascularization. Age, gender and left ventricular ejection fraction (LVEF) were similar in the four groups. Hard cardiac events (HEs) were noted in 14/33 (41%) patients with uncorrected hibernation, while in the other three groups HEs were recorded in fewer than 3% of patients. Univariate analysis indicated that the presence of hibernation, regardless of its extension, was the highest significant predictor of HEs. Multivariate analysis indicated that hibernation, stress ischaemia, age and absence of revascularization were significant predictors of HEs. These findings were not related to changes in LVEF or to New York Heart Association (NYHA) class during follow-up. In this routine based patient population, with mildly reduced VF, the rate of HEs seems to be related to uncorrected hibernation regardless of its extension. In these patients revascularization of hibernating segments is effective in reducing the risk of HEs while its role in improving VF or NYHA class is negligible.

Adult↗

Effects of coronary revascularisation on myocardial blood flow and coronary vasodilator reserve in hibernating myocardium.

OBJECTIVE: Previous studies have suggested that resting myocardial blood flow is within normal limits in most chronically dysfunctional left ventricular segments which improve function after coronary artery revascularisation (hibernating myocardium). The aim of this study was to assess myocardial blood flow and coronary vasodilator reserve in hibernating myocardium before and after coronary revascularisation. PATIENTS AND METHODS: 30 patients with multivessel coronary disease undergoing coronary revascularisation (21 patients with bypass grafting and nine with coronary angioplasty), and 21 age and sex matched healthy volunteers (controls). Myocardial blood flow (MBF, ml/min/g) was measured by positron emission tomography using oxygen-15 water at rest and after dipyridamole (MBFdip, 0.56 mg/kg in four minutes). Coronary vasodilator reserve was calculated as MBFdip/MBF. Regional wall motion was assessed with echocardiography. RESULTS: Before revascularisation there were 48 remote and 275 dysfunctional myocardial segments, of which 163 (59%) improved function after revascularisation (hibernating). In hibernating segments coronary vasodilator reserve before revascularisation was significantly lower than in remote segments (1.97 (0.7), p < 0.0001) and controls (3.2 (1.5), p < 0.0001). In hibernating segments, myocardial blood flow remained unchanged after revascularisation (0.94 (0.3) v 0.95 (0.3) ml/min/g, p = 0.3) while coronary vasodilator reserve increased (1. 47 (0.7) v 1.98 (1.0), p < 0.0001). Myocardial blood flow was similar in remote, hibernating segments before and after revascularisation and in controls. CONCLUSIONS: This study confirms that myocardial blood flow at rest in hibernating myocardium is within normal limits in most segments, and that hibernating myocardium is characterised by an impaired coronary vasodilator reserve which improves significantly after coronary revascularisation.

Adult↗

Pulsed wave tissue Doppler imaging for the quantification of contractile reserve in stunned, hibernating, and scarred myocardium.

OBJECTIVES: To assess whether quantification of myocardial systolic velocities by pulsed wave tissue Doppler imaging can differentiate between stunned, hibernating, and scarred myocardium. DESIGN: Observational study. SETTING: Tertiary referral centre. PATIENTS: 70 patients with reduced left ventricular function caused by chronic coronary artery disease. METHODS: Pulsed wave tissue Doppler imaging was done close to the mitral annulus at rest and during low dose dobutamine; systolic ejection velocity (Vs) and the difference in Vs between low dose dobutamine and the resting value (DeltaVs) were assessed using a six segment model. Assessment of perfusion (with Tc-99m-tetrofosmin SPECT) and glucose utilisation (by 18F-fluorodeoxyglucose SPECT) was used to classify dysfunctional regions (by resting cross sectional echocardiography) as stunned, hibernating, or scarred. RESULTS: 253 of 420 regions (60%) were dysfunctional. Of these, 132 (52%) were classified as stunned, 25 (10%) as hibernating, and 96 (38%) as scarred. At rest, Vs in stunned, hibernating, and scar tissue was, respectively, 6.3 (1.8), 6.6 (2.2), and 5.5 (1.5) cm/s (p = 0.001 by ANOVA). There was a gradual decline in Vs during low dose dobutamine infusion between stunned, hibernating, and scar tissue (8.3 (2.6) v 7.8 (1.5) v 6.8 (1.9) cm/s, p < 0.001 by ANOVA). DeltaVs was higher in stunned (2.1 (1.9) cm/s) than in hibernating (1.2 (1.4) cm/s, p < 0.05) or scarred regions (1.3 (1.2) cm/s, p = 0.001). CONCLUSIONS: Quantitative tissue Doppler imaging showed a gradual reduction in regional velocities between stunned, hibernating, and scarred myocardium. Dobutamine induced contractile reserve was higher in stunned regions than in hibernating and scarred myocardium, reflecting different severities of myocardial damage.

Cicatrix↗

Time course of functional recovery of stunned and hibernating segments after surgical revascularization.

BACKGROUND: Recovery of function is possible in patients with ischemic cardiomyopathy when left ventricular dysfunction is caused by stunning or hibernation. It is plausible that recovery of function after revascularization may take a longer time in hibernating myocardium compared with stunned myocardium. Accordingly, the time courses of functional recovery in hibernating and stunned myocardium were compared. METHODS AND RESULTS: Patients (n=26) with ischemic cardiomyopathy undergoing surgical revascularization were studied; regional perfusion (resting (201)Tl single-photon emission CT), glucose utilization ((18)F-2-deoxyglucose single-photon emission CT), and contractile function (2D echocardiography) were assessed before revascularization. Dysfunctional segments with normal perfusion/glucose utilization were considered to be stunned, and dysfunctional segments with reduced perfusion/preserved glucose utilization were considered to be hibernating. Contractile function was reevaluated 3 months (early) and 14 months (late) after revascularization. Of the 266 dysfunctional segments, 57 (22%) were stunned, 62 (23%) were hibernating, and 147 (55%) were scar tissue. In stunned myocardium, contractile function improved significantly at 3 months, without further improvement at 14 months; 61% of the stunned segments improved at 3 months, and 9% improved at 14 months. In hibernating myocardium, contractile function improved at 3 months, with a further improvement at 14 months; 31% of the hibernating segments improved at 3 months, and 61% showed (additional) recovery at 14 months. CONCLUSIONS: Stunned myocardium is likely to demonstrate early recovery of function, whereas hibernating myocardium may take a longer time to (fully) recover in function after revascularization.

Cardiomyopathies↗

[Reversible dysfunction of the left ventricle in coronary disease (part two): hibernation and methods for detection of viability].

HIBERNATION: Hibernating myocardium is defined as a state of persistently impaired myocardial function, as a consequence of reduced coronary flow, which can be partially or completely reversed if the myocardial oxygen consumption/demand ratio is favorably altered. Since it indicates concordance between flow and function (flow-function relation), it can be concluded that hibernating myocardium, caused by reduced myocardial perfusion, improves its function after surgical revascularization, giving its detection a great clinical importance. Hibernating myocardium can be found in majority of patients with coronary artery disease and chronic left ventricular dysfunction. These patients, even without typical symptoms of angina, will benefit from myocardial revascularization. This beneficial effect is expressed by ejection fraction enhancement, which is directly proportional to the number of dysfunctional, but viable segments. Also, symptom improvement depends on the mass of revascularized myocardium, which is previously shown to be viable. Having that in mind, the mass of viable myocardium must be large enough, so that the degree of expected improvement of myocardial function after revascularization justifies the operation itself. Opposing this classical concept of hibernating myocardium, recent studies have shown that in patients with coronary artery disease, coronary flow at rest is normal or just slightly reduced, which cannot explain the degree of myocardial dysfunction. According to that, it is proposed that myocardial dysfunction is, like in myocardial stunning, the result of flow-function mismatch, meaning that pathophysiology of hibernating myocardium includes a component of stunning as well. Therefore, hibernating myocardium can be defined as a form of reversible left ventricular dysfunction, caused by chronic coronary artery disease, which is partially due to episodes of repetitive stunning and shows improvement after inotropic stimulation. From practical point of view, it is important to detect hibernating myocardium in all patients with coronary artery disease and left ventricular dysfunction, since their treatment and prognosis directly depend on whether the dysfunction is reversible or not. METHODS FOR IDENTIFICATION OF MYOCARDIAL VIABILITY: Detection of myocardial viability has great clinical importance, since both regional and global left ventricular function can significantly improve, either spontaneously or by myocardial revascularization. Noninvasive imaging procedures used for that purpose include positron emission tomography, thallium-201 imaging, technetium-99 imaging, dobutamine echocardiography and tissue characterization. Using these methods, it is possible to assess the presence of viable tissue through evaluation of metabolic activity, integrity of myocyte membrane and the inotropic reserve of myocardium.

Coronary Disease↗

[Hibernating myocardium: no involvement of endogenous adenosine].

During moderate but nevertheless prolonged myocardial ischemia, the myocardium is dysfunctional but can remain viable. In such ischemic and dysfunctional myocardium, contractile function is reduced in proportion to the reduction in regional myocardial blood flow; i.e. a state of "perfusion-contraction matching" exists. The metabolic status of such myocardium improves over the first few hours, as myocardial lactate production is attenuated and creatine phosphate, after an initial reduction, returns towards control values. Ischemic myocardium, characterized by perfusion-contraction matching, metabolic recovery and lack of necrosis, has been termed "short-term hibernating myocardium". Short-term hibernating myocardium can respond to an inotropic stimulation with increased contractile function, however, at the expense of a renewed worsening of the metabolic status. This situation of an increased regional contractile function at the expense of metabolic recovery during inotropic stimulation can be used to identify short-term hibernating myocardium. A role for endogenous adenosine in the development of hibernation has been excluded, since neither contractile function nor metabolic parameters nor viability are altered by increased catabolism of endogenous adenosine by infusion of adenosine deaminase. Whereas short-term hibernation is well characterized in animal experiments, the existence of hibernation over weeks or months (long-term hibernation) can only be inferred from clinical studies. Hibernation, as defined by Rahimtoola, is a state of chronic contractile dysfunction in patients with coronary artery disease which is fully reversible upon reperfusion.

Adenosine↗

Nuclear bodies are usual constituents in tissues of hibernating dormice.

In previous studies we demonstrated in several tissues of the hazel dormouse Muscardinus avellanarius that during hibernation cell nuclei contain particular structural constituents absent in euthermia. In the present study we examine the same tissues in euthermic and hibernating individuals of the edible dormouse Glis glis in order to investigate possible modifications of nuclear structural constituents occurring during hibernation in this species. Edible dormice were captured in the wild and maintained in an external animal house. Samples of liver, pancreas, brown adipose tissue and adrenal cortex were taken from three hibernating and three euthermic animals and processed for resin embedding. Ultrastructural and immunocytochemical studies were carried out on cell nuclei of these tissues. The most evident feature of cell nuclei of hibernating dormice was the presence of several nuclear bodies, namely fibro-granular material, amorphous bodies, coiled bodies, perichromatin granule-like granules and nucleoplasmic fibrils, the distribution of which was peculiar to each tissue. No one of these constituents was detectable during euthermia. Immunocytochemical analyses revealed that they contain some splicing factors. Apart from some differences, maybe due to the different characteristics of lethargy, the nuclear bodies found in edible dormice were morphologically and immunocytochemically similar to those previously described in the same tissues of hazel dormice. They therefore seem to be strictly correlated to the hibernating state. If they represent storage and/or assembly sites of splicing factors to be rapidly used upon arousal, they could represent a usual structural feature in cells of hibernating species.

Adipose Tissue, Brown↗

Gene up-regulation in heart during mammalian hibernation.

A cDNA library prepared from heart of hibernating golden-mantled ground squirrels, Spermophilus lateralis, was differentially screened to clone genes that were up-regulated during hibernation. Two differentially expressed clones were found after three rounds of screening and were confirmed as up-regulated by Northern blotting. Clone Ang6 encoded a polypeptide with 116 amino acids that was identified as the ventricular isoform of myosin light chain 1 (MLC1(v)). Clone Ang19 coded for 274 amino acid residues of the mitochondrially encoded protein subunit 2 of NADH-ubiquinone oxidoreductase (ND2). Both proteins showed high amino acid sequence identity with their human counterparts, 97.5% for MLC1(v) and 66% for ND2. Northern blot hybridization revealed differential expression of these genes in multiple organs during hibernation. Transcript levels of both were approximately twofold higher in heart and three- to fourfold higher in skeletal muscle of hibernating, versus euthermic, animals. ND2 was also up-regulated in hibernator liver. Hibernation-induced up-regulation of MLC1(v) suggests that a restructuring of myosin subunit composition could contribute to changes in muscle contractility needed for hypothermic function, whereas changes in ND subunit composition may affect the function of the electron transport chain during hibernation.

Amino Acid Sequence↗

Ultrastructural changes in Paneth cells during hibernation in the ground squirrel Spermophilus lateralis.

The ultrastructure of Paneth cells from jejuno-ileal segments of the small intestine of the ground squirrel, S. lateralis, was examined under normal euthermic conditions and during the profoundly depressed metabolic conditions of natural hibernation. Paneth cells obtained from hibernating animals gave evidence of markedly reduced activity when compared to Paneth cells from euthermic animals. In hibernating animals, the nuclei were smaller, with less prominent nucleoli and with an increased proportion of heterochromatin, In hibernating animals, the rough endoplasmic reticulum was fragmentary and poorly organized, in contrast to the typical arrangement of concentric lamellae seen in euthermic animals. Although the total number of ribosomes was decreased in hibernating animals, there were proportionally more free ribosomes than in euthermic animals. Paneth cells from hibernating animals also contained a greater number of apical secretory granules which were smaller and more variable in electron density than granules from control animals. These ultrastructural features indicate that during hibernation the Paneth cell is relatively quiescent.

Animals↗

Effects of hibernation on somatostatin-like immunoreactivity in the brain of the ground squirrel (Spermophilus richardsonii) and European hedgehog (Erinaceus europaeus).

The localization of the somatostatin system in the brains of Richardson's ground squirrels (Spermophilus richardsonii) and European hedgehogs (Erinaceus europaeus) was described by use of immunocytochemical methods. In addition, (i) chemically differing types of somatostatin and (ii) different activity phases of the somatostatin system during the hibernation cycle were investigated in the ground squirrel by means of high pressure liquid chromatography (HPLC) and radioimmunoassay (RIA). In both species, the hypothalamic component of the somatostatin system (periventricular nuclei, fiber projections to the median eminence) is more prominent than the widespread extrahypothalamic representation of the system displaying mainly scattered perikarya and nerve fibers. The reactivity pattern of the somatostatin system varied among hibernating, aroused, and non-hibernating animals; moreover, the interspecific differences were pronounced. The activity of the hypothalamic somatostatin system in the hibernating ground squirrel appeared to be suppressed when compared to non-hibernating controls, whereas in the hibernating hedgehog this system showed signs of increased activity in comparison to non-hibernating controls. In contrast, in the present material the extrahypothalamic components of the somatostatin system did not exhibit significant changes in their activity.

Animals↗

Reduction of metabolism during hibernation and daily torpor in mammals and birds: temperature effect or physiological inhibition?

The present study addresses the controversy of whether the reduction in energy metabolism during torpor in endotherms is strictly a physical effect of temperature (Q10) or whether it involves an additional metabolic inhibition. Basal metabolic rates (BMR; measured as oxygen consumption, VO2), metabolic rates during torpor, and the corresponding body temperatures (Tb) in 68 mammalian and avian species were assembled from the literature (n = 58) or determined in the present study (n = 10). The Q10 for change in VO2 between normothermia and torpor decreased from a mean of 4.1 to 2.8 with decreasing Tb from 30 to less than 10 degrees C in hibernators (species that show prolonged torpor). In daily heterotherms (species that show shallow, daily torpor) the Q10 remained at a constant value of 2.2 as Tb decreased. In hibernators with a Tb less than 10 degrees C, the Q10 was inversely related to body mass. The increase of mass-specific metabolic rate with decreasing body mass, observed during normothermia (BMR), was not observed during torpor in hibernators and the slope relating metabolic rate and mass was almost zero. In daily heterotherms, which had a smaller Q10 than the hibernators, no inverse relationship between the Q10 and body mass was observed, and consequently the metabolic rate during torpor at the same Tb was greater than that of hibernators. These findings show that the reduction in metabolism during torpor of daily heterotherms and large hibernators can be explained largely by temperature effects, whereas a metabolic inhibition in addition to temperature effects may be used by small hibernators to reduce energy expenditure during torpor.

Animals↗

Pancreatic A and B cell stimulation in euthermic and hibernating marmots (Marmota flaviventris): effects of glucose and arginine administration.

In euthermic and hibernating marmots (Marmota flaviventris), the pancreatic A and B cells respond in the appropriate secretory manner to glucose or arginine injection. Although reduced, this response, is clearly present in hibernating marmots. When glucose is administered to euthermic or hibernating marmots, plasma insulin concentrations rise and glucagon levels fall. While similar results are obtained in hibernation, the time period of the response is much longer due to the slowing of temperature dependent metabolic processes. Injection of L-arginine stimulates an increase in plasma glucose, insulin, and glucagon as expected. Measurements of plasma glucose, insulin, and glucagon under basal conditions, suggest that there are no significant differences between any phase of hibernation (eg. entrance, deep hibernation, arousal) and euthermia. These results provide indirect evidence that the pancreatic A and B cells of hibernating marmots continue to function in order to help regulate plasma glucose concentration.

Animals↗

Timing of torpor bouts during hibernation in European hamsters (Cricetus cricetus L.).

Body temperature (Tb) of seven European hamsters maintained at constant ambient temperature (Ta = 8 degrees C) and constant photoperiod (LD 8:16) was recorded throughout the hibernating season using intraperitoneal temperature-sensitive HF transmitters. The animals spent about 30% of the hibernation season in hypothermia and 70% in inter-bout normothermy. Three types of hypothermia, namely deep hibernation bouts (DHBs), short hibernation bouts (SHBs), and short and shallow hibernation bouts (SSHBs), were distinguished by differences in bout duration and minimal body temperature (Tm). A gradual development of SSHBs from the diel minimum of Tb during normothermy could be seen in individual hamsters, suggesting a stepwise decrease of the homeostatic setpoint of Tb regulation during the early hibernation season. Entry into hibernation followed a 24-h rhythm occurring at preferred times of the day in all three types of hypothermia. DHBs and SHBs were initiated approximately 4 h before SSHBs, indicating a general difference in the physiological initiation of SSHBs on the one hand and DHBs and SHBs on the other. Arousals from SHBs and SSHBs also followed a 24-h rhythm, whereas spontaneous arousals from DHBs were widely scattered across day and night. Statistical analyses of bout length and the interval between arousals revealed evidence for a free-running circadian rhythm underlying the timing of arousals. The results clearly demonstrate that entries into hypothermia are linked to the light/dark-cycle. However, the role of the circadian system in the timing of arousals from DHBs remains unclear.

Animals↗

Gradual reappearance of post-hibernation circadian rhythmicity correlates with numbers of vasopressin-containing neurons in the suprachiasmatic nuclei of European ground squirrels.

European ground squirrels (Spermophilus citellus) in outside enclosures show suppressed circadian rhythmicity in body temperature patterns during the first days of euthermia after hibernation. This may reflect either gradual reappearance of circadian rhythmicity following suppressed functioning of the circadian system during hibernation, or it may reflect transient days during re-entrainment of the circadian system which, during hibernation, has drifted out of phase with the environmental light-dark cycle. Here we report that animals kept under continuous dim light conditions also showed absence of circadian rhythmicity in activity and body temperature in the first 5-15 days after hibernation. After post-hibernation arrhythmicity, spontaneous circadian rhythms re-appeared gradually and increased daily body temperature range. Numbers of arginine-vasopressin immunoreactive neurons in the suprachiasmatic nuclei correlated positively with individual circadian rhythmicity and increased gradually over time after hibernation. Furthermore, circadian rhythmicity was enhanced rather than suppressed after exposure to a light-dark cycle but not after a single 1-h light pulse (1,700 lux). The results support the view that the functioning of the circadian system in the European ground squirrel is suppressed during hibernation at low temperatures and that it requires several days of euthermia to resume its summer function.

Animals↗

Nucleoli undergo structural and molecular modifications during hibernation.

The nucleolus is a very dynamic structure able rapidly to adapt its activity to the cellular metabolic state. An interesting physiological model characterized by drastic modifications of cellular metabolism is represented by hibernating animals. In the present study we investigated the hepatocyte nuclei of euthermic and hibernating edible dormice (Glis glis) with the aim of revealing, by means of ultrastructural and immunocytochemical analyses, possible modifications of nucleolar components during hibernation. Our observations demonstrate that, in deep hibernation, nucleoli undergo structural and molecular modifications: (a) they show numerous nucleoplasmic invaginations and clumps of dense fibrillar component extend from the nucleolar surface; (b) they are frequently in contact with coiled bodies and fibro-granular material, two nuclear bodies usually occurring in the nucleoplasm; (c) the dense fibrillar component contains significant amounts of small nuclear ribonucleoproteins, splicing factors usually distributed in the nucleoplasm. Taken together, these results suggest that during hibernation complex relationships are established between the nucleolus and nucleoplasm, probably related to functional activities peculiar to this physiological phase. However, since no evident nucleolar modification was found in early hibernating dormice, it seems likely that the particular structural and molecular arrangement of nucleoli establishes progressively during hibernation, becoming evident only in the deepest phase, and then disappears upon arousal.

Animals↗

Up-regulation of the endoplasmic reticulum molecular chaperone GRP78 during hibernation in thirteen-lined ground squirrels.

Hibernating mammals endure conditions of low body temperature and oxidative stress that would be highly injurious to humans and most other mammals. Stress conditions frequently trigger the production of molecular chaperones; in the endoplasmic reticulum the glucose-regulated protein-78 (GRP78) helps to minimize protein misfolding under stress. The present study evaluated the GRP78 response in seven organs of hibernating thirteen-lined ground squirrels, Spermophilus tridecemlineatus. Transcript levels of grp78, assessed by RT-PCR, were significantly higher (3.5- to 4.1-fold) in brown adipose tissue and brain of hibernating squirrels compared with euthermic control animals but remained low or stable in all other tissues. GRP78 protein content, assessed by Western blotting, was also elevated in brown adipose and brain during hibernation by 1.4-1.6 fold. A 2490 bp cDNA sequence was retrieved that contained the full length open reading frame of ground squirrel grp78 and the translated protein sequence of 654 amino acids shared 98-99% identity with GRP78 from other mammalian sources. Selected specific amino acid substitutions were found in the ground squirrel sequence that may aid GRP78 function under the near 0 degrees C body temperatures of the hibernating state. Electrophoretic mobility shift and supershift assays showed that the activating transcription factor, ATF4, binds to the promoter region of the grp78 gene in ground squirrel brain and may be responsible for grp78 up-regulation during hibernation. Changes in grp78 gene and protein expression appear to aid stress tolerance in two highly oxygen-dependent organs that are critical to whole animal survival during hibernation.

Activating Transcription Factor 4↗

Regional changes in central monoamine and metabolite levels during the hibernation cycle in the golden-mantled ground squirrel.

We assayed various brain regions for levels of monoamines and their metabolites throughout the hibernation cycle of the golden-mantled ground squirrel Spermophilus lateralis. The tissue concentrations of serotonin, dopamine, norepinephrine and their metabolites were determined in the parietal cortex, striatum, midbrain, hippocampus, hypothalamus, and pons. Telencephalic regions exhibited the most significant variations in biogenic amine content. Cortical serotonin (5-HT) levels increased significantly at entrance (P less than 0.0001) relative to other periods of the hibernation cycle, suggesting a role for 5-HT in the initiation of hibernation. Among striatal dopamine (DA) metabolites, 3-methoxytyramine was detectable only during euthermia and arousal; from entrance through arousal, homovanillic acid (HVA) levels were half that found during euthermia (P = 0.0001); and dihydroxyphenylacetic acid (DOPAC) levels increased during day 1 of hibernation (P less than 0.0005). Midbrain DA (P = 0.0295) and hippocampal HVA (P = 0.0194) levels also changed significantly across the hibernation bout. The absence of a consistent change in any monoamine or metabolite throughout the brain precludes the possibility of preferential temperature-dependent impairment of an enzyme involved in biogenic amine synthesis or degradation and suggests that the levels observed reflect changes in neural activity specific to each brain region. Together with previous studies of brain 2-deoxyglucose uptake throughout the hibernation cycle, these data indicate that a transient change in afferent monoaminergic metabolism and neurotransmission in the forebrain is a necessary component for the entrance to hibernation.

Action Potentials↗

The hibernator heart--nature's model of resistance to ventricular fibrillation.

During hibernation animals decrease their body temperature down to a few degrees above 0 degrees C. This means that when entering into and arousing from hibernation their body temperature passes through the critical level of 20 degrees C, a temperature region where nonhibernating mammals develop circulatory arrest, usually ventricular fibrillation (VF). The hibernator heart is resistant to VF, not only induced by hypothermia, but also when induced by local application of aconitine on the epicardium, and other ways of inducing VF in nonhibernators. Several mechanisms may explain this resistance to VF of the hibernator heart. The factors of greatest importance seem to be the different adrenergic innervation pattern, the different physico-chemical properties with a lower melting point of the lipids in the hibernator, the different enzyme temperature activity curves in the hibernator and the different handling of intracellular calcium, which results in protection against calcium overload in the hibernator heart, when compared with the nonhibernator heart.

Animals↗