"Hibernating" myocardium: not only a matter of semantics.

Matter of Semantics To the Editor: The recent article by Kalra et al1 reiterates the use of the term “hibernating myocardium,” which was introduced by Diamond et al in 19782 to indicate a state of chronically ischemic noninfarcted myocardium. The term is incorrect and should be abandoned. In Dorland’s Illustrated Medical Dictionary, hibernation is defined as “the dormant state in which certain animal species pass the winter; it is characterized by narcosis and by sharp reduction in body temperature and metabolic activity.”3 The so-called “hibernating myocardium” is a condition of viable but dormant myocardium, which has nothing to share with reduction in body temperature. The term hibernation is derived from the Latin “hiberna,” which means “winter” and clearly refers to cold temperature. We are aware of only one condition of hibernating myocardium in humans, and that is the heart during hypothermic circulatory arrest in cardiac surgery. “Hibernating” myocardium is a misnomer due to lack of knowledge of classics, and it is depressing to realize how much modern medicine accepts unsound neologisms with supine resignation. Sawyer and Loscalzo in their editorial4 define it as a “reversible sleep.” We believe that the best term is myocardial “lethargy.” In the Shorter Oxford English Dictionary, lethargy, which derives from the Greek word lethargia ( ), is defined as “morbid drowsiness or prolonged and unnatural sleep”; in other words, a pathological dormant state.5 Whatever the final choice of nomenclature, the use of accurate terminology has basic implications in science for a precise way of thinking and for a better understanding of disease processes. Semantics, which is the study of the meanings of words and the rules of their use, is wrongly thought to be useless. Modern medicine is science in so far as it respects the relationship between language and significance. In the past, it was popularly believed that study of Latin, if not of Greek, was a prerequisite for the study of medicine. Although this is no longer enforceable, by leafing through a medical dictionary, one can estimate that as much as 75% of scientific words are of Greek or Latin derivation.