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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Assessment of myocardial viability in patients with heart failure

Arend F L Schinkel1, Don Poldermans, Abdou Elhendy

  • 1Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|June 19, 2007
PubMed

Insights

Assessing myocardial viability noninvasively is crucial for managing chronic ischemic left ventricular dysfunction. Techniques like PET and MRI can identify viable heart muscle, guiding revascularization decisions for improved patient outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Chronic ischemic left ventricular dysfunction carries a poor prognosis despite current therapies.
  • Accurate assessment of myocardial viability is essential for guiding patient management and treatment strategies.

Purpose of the Study:

  • To review and compare noninvasive imaging techniques for assessing myocardial viability.
  • To evaluate the role of these techniques in predicting outcomes after coronary revascularization.

Main Methods:

  • Evaluation of multiple imaging modalities including Positron Emission Tomography (PET), thallium-201 ((201)Tl) and technetium-99m ((99m)Tc) scintigraphy, dobutamine stress echocardiography, and Magnetic Resonance Imaging (MRI).
  • Assessment criteria included perfusion, cell membrane integrity, mitochondrial function, glucose metabolism, scar tissue, and contractile reserve.

Main Results:

  • Nuclear imaging techniques demonstrate high sensitivity for detecting myocardial viability.
  • Contractile reserve assessments offer lower sensitivity but higher specificity.
  • MRI provides high accuracy in determining the extent of myocardial scar tissue.

Conclusions:

  • Patients with significant dysfunctional but viable myocardium are likely to benefit from coronary revascularization.
  • Successful revascularization can lead to improvements in cardiac function, symptoms, exercise capacity, and long-term prognosis.

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