A 58-Year-Old Man with Dyspnea and Chronic Exertional Angina Is

A 58-year-old man with dyspnea and chronic exertional angina is evaluated for coronary revascularization.  He has a history of hypertension, type 2 diabetes mellitus, and hypercholesterolemia.  His blood pressure is 130/80 mm Hg and pulse is 72/min and regular.  Cardiopulmonary examination is normal with the exception of a fourth heart sound.  Echocardiogram reveals hypokinesia of the anterior wall of the left ventricle and a left ventricular ejection fraction (LVEF) of 35%.  The patient undergoes coronary artery bypass grafting.  Repeat echocardiogram 10 days after the surgery shows that hypokinesia is no longer evident and LVEF has increased to 50%.  Which of the following best explains the changes in the cardiac contractility and wall motion seen in this patient?

A) Hibernating myocardium
B) Ischemic preconditioning
C) Post-infarction myocardial scarring
D) Reperfusion injury
E) Ventricular remodeling

Correct Answer:

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