Critical role of energy supply and glycolysis during short-term hibernation

The terms “acute hibernation” and “short-term hibernation” may seem oxymoronic since “hibernation” implies a prolonged period of dormancy and subsequent reawakening. Nonetheless, the concept of acute hibernation has provided a useful framework for research studies involving relatively brief periods of low flow or moderate ischemia which depress myocardial function but do not cause homogeneous irreversible injury; therefore significant recovery or “reawakening” of the ischemically depressed myocardium can occur with reperfusion. The sequence of relatively brief ischemia followed by reperfusion has obvious relevance to clinical scenarios of unstable angina, acute coronary thrombosis and impending myocardial infarction which is treated with thrombolytic therapy, and the ischemia-reperfusion sequence which accompanies cardiac surgery. The mechanisms regulating acute hibernation during low-flow ischemia and recovery during reperfusion merit serious investigation because of their clinical relevance and potential for beneficial therapeutic manipulation.