MINI-SYMPOSIUM

Fundamental concepts in myocardial viability assessment revisited: when knowing how much is "alive" is not enough

R J Kim, D J Shah

Duke Cardiovascular Magnetic Resonance Center and Division of Cardiology, Duke University Medical Center, Durham, North Carolina, USA

Correspondence to:
Correspondence to:
Raymond J Kim
MD, Duke Cardiovascular MRI Center, DUMC-3934, Durham, NC 27710, USA; Raymond.Kim@dcmrc.mc.duke.edu

Keywords: myocardial viability; magnetic resonance imaging

Abbreviations: DSE, dobutamine stress echocardiography; LV, left ventricle; MRI, magnetic resonance imaging; PET, positron emission tomography; SPECT, single photon emission computed tomography

The first 150 words of the full text of this article appear below.

In recent years, it has become evident that myocardial dysfunction in ischaemic heart disease is not always a result of infarction and that contractile function can improve significantly after revascularisation.¹² A number of non-invasive techniques have been developed in an attempt to identify these patients with dysfunctional but viable myocardium, since it is generally agreed that it is this group, as compared to the group with irreversible myocardial damage, that has a favourable clinical risk-to-benefit profile for undergoing coronary revascularisation. The primary aim of these non-invasive techniques is to provide a regional map of the heart in which the amount of viable myocardium is quantified. Unfortunately, currently available techniques, such as single photon emission computed tomography (SPECT), dobutamine stress echocardiography (DSE), and positron emission tomography (PET), have various limitations. For example, what is measured may not be the direct presence and exact quantity of viable myocytes, but a physiologic parameter, . . . [Full text of this article]

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