HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Activity All Versions of this Article: jnumed.106.038851v1 48/7/1135    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JNM Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schinkel, A. F.L. Articles by Bax, J. J. Search for Related Content PubMed PubMed Citation Articles by Schinkel, A. F.L. Articles by Bax, J. J.

Assessment of Myocardial Viability in Patients with Heart Failure^*

¹ Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands; ² Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin; and ³ Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands

Correspondence: For correspondence or reprints contact: Jeroen J. Bax, Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. E-mail: j.j.bax{at}lumc.nl

The prognosis for patients with chronic ischemic left ventricular dysfunction is poor, despite advances in different therapies. Noninvasive assessment of myocardial viability may guide patient management. Multiple imaging techniques have been developed to assess viable and nonviable myocardium by evaluating perfusion, cell membrane integrity, mitochondria, glucose metabolism, scar tissue, and contractile reserve. PET, ²⁰¹Tl and ^99mTc scintigraphy, and dobutamine stress echocardiography have been extensively evaluated for assessment of viability and prediction of clinical outcome after coronary revascularization. In general, nuclear imaging techniques have a high sensitivity for the detection of viability, whereas techniques evaluating contractile reserve have a somewhat lower sensitivity and a higher specificity. MRI has a high diagnostic accuracy for assessment of the transmural extent of myocardial scar tissue. Patients with a substantial amount of dysfunctional but viable myocardium are likely to benefit from coronary revascularization and may show improvements in regional and global contractile function, symptoms, exercise capacity, and long-term prognosis.

Key Words: myocardial viability • heart failure • noninvasive imaging • prognosis • stunning • hibernation

^* NOTE: FOR CE CREDIT, YOU CAN ACCESS THIS ACTIVITY THROUGH THE SNM WEB SITE (http://www.snm.org/ce_online) THROUGH JULY 2008.

No potential conflict of interest relevant to this article was reported.

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

Related articles in JNM:

This Month in JNM

JNM 2007 48: 11a-12a. [Full Text]  

This article has been cited by other articles:

				Authors/Task Force Members, K. Dickstein, A. Cohen-Solal, G. Filippatos, J. J.V. McMurray, P. Ponikowski, P. A. Poole-Wilson, A. Stromberg, D. J. van Veldhuisen, D. Atar, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur. Heart J., October 1, 2008; 29(19): 2388 - 2442. [Full Text] [PDF]

				K. L. Gould Not All Randomized Trials Are Equal J. Am. Coll. Cardiol., November 13, 2007; 50(20): 2013 - 2015. [Full Text] [PDF]