Myocardial “stunning” in man
R. Bolli

This landmark paper by Bolli on the clinical relevance of myocardial stunning is the first attempt to build a bridge between laboratory and real clinical conditions. Clinically, stunning is the mechanical dysfunction that persists after reperfusion despite the absence of irreversible damage and restoration of normal or near-normal coronary flow...

Low-dose dobutamine echocardiography detects reversible dysfunction after thrombolytic therapy of acute myocardial infarction
S.C. Smart, S. Sawada, T. Ryan, D. Segar, L. Atherton, K. Berkovitz, P.D.V. Bourdillon, H. Feigenbaum

This paper addresses the crucial issue of whether myocardial stunning may occur after thrombolytic treatment of acute myocardial infarction and whether low-dose dobutamine echocardiography may be useful in distinguishing reversible from irreversible injury after thrombolytic therapy...

Time course of functional improvement in stunned myocardium in risk area in patients with reperfused anterior infarction
H. Ito, T. Tomooka, N. Sakai, Y. Higashino, K. Fujii, O. Katoh, T. Masuyama, A. Kitabatake, T. Minamino

Myocardial stunning was first described and its mechanisms characterized in the dog heart. Indeed, stunning has been described as an experimental phenomenon in search of a clinical manifestation...

Marked reduction of free radical generation and contractile dysfunction by antioxidant therapy begun at the time of reperfusion
R. Bolli, M.O. Jeroudi, B.S. Patel, O.I. Aruoma, B. Halliwell, E.K. Lai, P.B. McCay

In this key paper Bolli et al discuss the complex and controversial issue of “reperfusion injury,” whether it exists, and which mechanisms are involved...

Cellular mechanisms of myocardial stunning
H. Kusuoka, E. Marban

After stressing that stunning can only be studied in models that allow the myocardium to be vascularly perfused, rendered truly ischemic, and reperfused via the native coronary circulation, explaining the usual choice of the intact canine heart model, Kusuoka and Marban suggest using the isolated perfused heart model...

Mechanism of myocardial stunning
R. Bolli

Although now 6 years old, there can be little doubt that this review has stood the test of time and that it is surely required reading for anyone interested in myocardial stunning and its possible clinical relevance...

Demonstration of free radical generation in the “stunned” myocardium in the conscious dog and identification of major differences between conscious and open-chest dogs
X.Y. Li, P.B. McCay, M. Zughaib, M.O. Jeroudi, J. F. Triana, R. Bolli

This paper describes yet another key investigation from the laboratory of Bolli and colleagues who have contributed greatly to our understanding of the genesis, mechanisms, and pharmacological control of myocardial stunning, notably by providing strong evidence that stunning is, at least in part, a manifestation of reperfusion injury and that this injury is caused, again at least in part, by free radical-mediated injury resulting from a transient but severe burst of radical production during the early minutes of reperfusion...

Mechanisms of chronic regional postischemic dysfunction in humans: new insights from the study of noninfarcted collateral-dependent myocardium
J.L.J. Vanoverschelde, W. Wijns, C. Depré, B. Essamri, G.R. Heyndrickx, M. Borgers, A. Bol, J.A Melin

In this interesting study, Vanoverschelde and colleagues address the issue of patients with coronary artery disease who have not suffered a myocardial infarction and who present wallmotion abnormalities that are reversible either spontaneously or after recanalization...

Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium
V. Dilsizian, R. Bonow

This review by Dilsizian and Bonow on the differentiation of viable from nonviable myocardium in patients with coronary artery disease and left ventricular dysfunction - an issue of increasing clinical relevance - represents a substantial contribution to improving the management of such patients...

Occurrence of oxidative stress during reperfusion of the human heart
R. Ferrari, O. Alfieri, S. Curello, C. Ceconi, A. Cargnoni, P. Marzollo, A. Pardini, E. Caradonna, O. Visioli

This article addresses for the first time the existence of a possible link between oxidative stress and stunning occurring immediately after aortocoronary bypass grafting in humans...