TY - JOUR
T1 - Detection of viability after myocardial infarction
T2 - available techniques and clinical relevance - a review
AU - Huitink, Johannes M.
AU - Visser, Frans C.
AU - Bax, Jeroen J.
AU - Visser, Cees A.
PY - 1995/1/1
Y1 - 1995/1/1
N2 - The differentiation of viable from nonviable myocardium in patients with myocardial infarction (MI) and left ventricular (LV) dysfunction is of important clinical relevance. It is now known that impaired LV function after infarction not always represents an irreversible process. LV ejection fraction is significantly reduced in many patients after infarction and, although abnormally contracting myocardial segments may result from irreversible scarring, numerous studies have shown that many asynergic zones have sustained metabolic activity. An accurate detection of myocardial viability aids in clinical decision making to select the appropriate therapy for patients with MI. Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of myocardial perfusion, cell membrane integrity, metabolic activity and residual coronary reserve, have been developed with clinical success. These methods provide greater precision in the assessment of viable myocardium than can be achieved by analysis or coronary anatomy, regional function or the presence or absence of electrocardiographic Q waves, criteria that were used in the past. The clinical challenge is to predict which myocardial regions are viable and will improve systolic function after revascularization, thereby enhancing global LV function. In this review, the currently available imaging techniques for assessment of myocardial viability are discussed.
AB - The differentiation of viable from nonviable myocardium in patients with myocardial infarction (MI) and left ventricular (LV) dysfunction is of important clinical relevance. It is now known that impaired LV function after infarction not always represents an irreversible process. LV ejection fraction is significantly reduced in many patients after infarction and, although abnormally contracting myocardial segments may result from irreversible scarring, numerous studies have shown that many asynergic zones have sustained metabolic activity. An accurate detection of myocardial viability aids in clinical decision making to select the appropriate therapy for patients with MI. Recently, cardiac imaging techniques that evaluate myocardial viability on the basis of myocardial perfusion, cell membrane integrity, metabolic activity and residual coronary reserve, have been developed with clinical success. These methods provide greater precision in the assessment of viable myocardium than can be achieved by analysis or coronary anatomy, regional function or the presence or absence of electrocardiographic Q waves, criteria that were used in the past. The clinical challenge is to predict which myocardial regions are viable and will improve systolic function after revascularization, thereby enhancing global LV function. In this review, the currently available imaging techniques for assessment of myocardial viability are discussed.
KW - Clinical relevance
KW - Myocardial infarction
KW - Viability
UR - http://www.scopus.com/inward/record.url?scp=0028839733&partnerID=8YFLogxK
U2 - 10.1016/0167-5273(95)02430-5
DO - 10.1016/0167-5273(95)02430-5
M3 - Review article
C2 - 8586474
AN - SCOPUS:0028839733
VL - 51
SP - 253
EP - 266
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 3
ER -