Abstract
The review article provides a comprehensive analysis of the pathophysiology, diagnostic approaches, and therapeutic strategies for managing hibernating myocardium. This condition arises as an adaptive response of the myocardium to chronic ischemia, leading to a persistent reduction in contractile function while preserving cellular viability. Unlike infarcted myocardial tissue, hibernating myocardium retains the potential for functional recovery if adequate reperfusion is achieved through timely and appropriate interventions. The article explores the underlying molecular and metabolic mechanisms of HM, highlights the latest advancements in diagnostic imaging techniques for its identification, and discusses contemporary treatment modalities, including
pharmacological approaches and revascularization strategies. Additionally, the potential role of novel therapeutic agents, such as neprilysin inhibitors, in improving myocardial perfusion and function is examined, underscoring the need for further research to optimize clinical management of patients with chronic ischemic heart disease and heart failure.