Diastolic hibernation masquerading as constrictive pericarditis

Background: Hibernating myocardium has traditionally been characterized in terms of systolic dysfunction. Methods: We describe a case in which a 75-year-old patient with significant coronary artery disease was operated upon for classic constrictive pericarditis, Results: At sternotomy, there was no evidence of pericarditis, but marked diastolic without systolic dysfunction remained, After successful coronary revascularization, the patient immediately exhibited dramatic improvement of diastolic performance. Ex vivo evaluation of myocardial contractile function revealed normal myocardial adrenergic responsiveness, indicating a reversible impairment of contractility, Conclusion: Diastolic hibernation may therefore represent a unique form of surgically correctable restrictive cardiomyopathy.