Document Detail

Assessment of myocardial viability in chronic ischemic heart disease: current status.
MedLine Citation:
PMID:  15724138     Owner:  NLM     Status:  MEDLINE    
Assessment of myocardial viability is clinically important in the work-up of patients with ischemic cardiomyopathy. Numerous studies in the past 2 decades demonstrated that revascularization improves left ventricular ejection fraction (LVEF), heart failure symptoms and prognosis in patients with viable myocardium. Conversely patients without viable tissue do not benefit from revascularization. Also, a substantial amount of viable myocardium (at least 25% of the left ventricle) is needed to result in improvement of LVEF. Hence, both identification and quantification of the extent of viable myocardium are required for a careful selection of candidates for revascularization. Indeed, the presence of a substantial amount of viable myocardium decreases the risk of surgery in patients with reduced LVEF. Several diagnostic techniques are available to identify myocardial viability. Positron emission tomography (PET), myocardial perfusion imaging, and stress echocardiography are considered the traditional techniques to evaluate myocardial viability. Recently, newer techniques including cardiac magnetic resonance (CMR), myocardial contrast echocardiography (MCE) and electromechanical mapping have been introduced. In this manuscript the status of the currently available techniques to assess viability was reviewed. Also the relative merits of each technique for prediction of functional recovery and prognosis was addressed. The available retrospective data support the clinical use of viability assessment. Patients with ischemic cardiomyopathy should undergo viability testing to determine therapeutic strategy. In the presence of substantial amount of viable myocardium, patients should undergo revascularization since benefits in terms of left ventricular function, remodeling, symptoms and prognosis may be anticipated. However, prospective randomized trial are needed to confirm these data.
V Rizzello; D Poldermans; J J Bax
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutical Chemistry and Biology     Volume:  49     ISSN:  1824-4785     ISO Abbreviation:  -     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-22     Completed Date:  2005-06-24     Revised Date:  2005-12-20    
Medline Journal Info:
Nlm Unique ID:  101213861     Medline TA:  Q J Nucl Med Mol Imaging     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  81-96     Citation Subset:  IM    
Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
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MeSH Terms
Body Surface Potential Mapping / methods,  trends*
Echocardiography / methods,  trends*
Magnetic Resonance Imaging / methods,  trends*
Myocardial Ischemia / complications,  diagnosis*
Radionuclide Imaging / methods,  trends*
Risk Assessment / methods,  trends
Risk Factors
Ventricular Dysfunction, Left / diagnosis*,  etiology

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