Could diagnosis of hibernation avoid unnecessary heart transplantation?
In patients with coronary artery disease, cardiomyopathy is a primary indication for heart transplantation, accounting for 40–50% of transplantations performed [66, 67]. Due to the severe shortage of donor hearts, only 10% of eligible patients will undergo transplantation. The others have a high mortality despite aggressive medical therapy, 2-year survival being only 31% [68]. In view of this situation it is not surprising that myocardial revascularization has often been offered before heart transplantation for patients with severe ischemic cardiomyopathy. Cardiac surgeons, however, remain concerned when a patient undergoing coronary revascularization has an ejection fraction of less than 30% and symptoms of heart failure without angina [69]. They complain about lack of criteria to predict which patient will benefit from reperfusion. Knowing that a large portion of dysfunctional myocardium is viable rather than fibrotic and has the potential of functional recovery upon reperfusion, has
