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Assessing the available techniques for testing myocardial viability: what does the future hold?
MedLine Citation:
PMID:  23176686     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Left ventricular dysfunction in the setting of severe coronary artery disease poses a major diagnostic and therapeutic dilemma. While this clinical scenario is generally associated with poor outcomes, some but not all patients benefit from coronary revascularization. For example, patients with severe, transmural myocardial infarctions may derive little or no functional benefit from revascularization, as the underlying myocardium is irreversibly scarred. Furthermore, these patients may be exposed to high procedural risks with a low likelihood of deriving any perceivable benefit. Conversely, hibernating myocardium reflects a substrate whereby the nonfunctioning myocytes are chronically ischemic but may be viable. Existing data are somewhat inconclusive with regard to the benefits of performing viability testing in patients with ischemic cardiomyopathy. While this testing may predict regional and global functional myocardial recovery, the ability of viability studies to predict survival and prognosis remains unproven in prospective studies to date. Yet, viability testing may still be a valuable tool to guide therapeutic options in selected patients. A variety of noninvasive viability tests are available and newer technologies, such as PET and cardiac MRI, are likely to advance the scientific field in years to come.
Authors:
Brian P Shapiro; Patricia J Mergo; Christopher O Austin; Birgit Kantor; Thomas C Gerber
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Future cardiology     Volume:  8     ISSN:  1744-8298     ISO Abbreviation:  Future Cardiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101239345     Medline TA:  Future Cardiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  819-36     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. shapiro.brian@mayo.edu.
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