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Updated: Jun 22, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
Relationship between myocardial viability and coronary run-off in jeopardized myocardium
Hakimeh Sadeghian1, Ebrahim Nematipour, Masoumeh Lotfi-Tokaldany
1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. sadeghianhakimeh@yahoo.com
Insights
Coronary artery disease patients with reduced ejection fraction showed varying myocardial viability based on coronary run-off. Apical regions were more prone to nonviability despite good flow, while basal segments retained viability even with poor run-off.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Myocardial Perfusion
Background:
- Coronary artery disease (CAD) with left ventricular systolic dysfunction (LVSD) poses significant clinical challenges.
- Assessing myocardial viability is crucial for guiding revascularization strategies in these patients.
- Coronary run-off, a measure of distal perfusion, may influence myocardial viability.
Purpose of the Study:
- To investigate the relationship between coronary run-off and myocardial viability in jeopardized myocardial regions.
- To determine if coronary run-off patterns correlate with the extent of viable myocardium in patients with significant coronary stenosis and LVSD.
Main Methods:
- Fifty patients (40 male, mean age 55.6 years) with >70% coronary artery stenosis and ejection fraction <40% were studied.
- Myocardial viability was assessed using dobutamine stress echocardiography.
- Coronary run-off was evaluated and categorized as good or no run-off.
Main Results:
- Apical segments showed higher nonviability (67%) with good run-off compared to basal segments (15%).
- Basal segments exhibited greater viability (81%) with no run-off compared to apical segments (28%).
- Nonviability increased significantly from basal to apical regions, irrespective of run-off status (p < 0.001 for good run-off, p = 0.004 for no run-off).
Conclusions:
- Apical myocardial regions are more susceptible to nonviability, even with good coronary run-off.
- Basal segments demonstrate preserved viability despite compromised coronary run-off.
- These findings aid in identifying patients with CAD and LVSD who may benefit from revascularization.
Objective:
The aim of this study was to evaluate the relationship between coronary run-off and myocardial viability in jeopardized regions.
Method:
We studied 50 patients (40 male, mean age: 55.63 +/- 10.54 years) with coronary artery stenosis >70% and ejection fraction <40% referred for viability study via dobutamine stress echocardiography. The relationship between coronary run-off and viability was evaluated. Good run-off demonstrates good or moderate and no run-off means poor or no run-off.
Results:
In the apical region, 33% of the segments with good antegrade run-off were viable and 67% nonviable. Also, 72% of the segments with no run-off were nonviable and 28% viable. In the midportion region, 70% of the segments with good antegrade run-off were viable and 30% nonviable; 50% of the segments with no run-off were nonviable and 50% viable. In the basal region, 85% of the segments with good antegrade run-off were viable and 15% nonviable; 19% of the segments with no run-off were nonviable and 81% viable. The proportion of the nonviable segments increased significantly from the basal to apical regions either with good (p < 0.001) or no run-off (p = 0.004). From 239 viable segments, 58.6% had antegrade, 15.4% retrograde, and 25.5% no run-off. Of 181 nonviable segments, 44% had antegrade, 34% retrograde, and 34.8% no run-off.
Conclusion:
There was more susceptibility to nonviability in the apical regions despite good run-off, while the basal segments showed more viability in spite of having no run-off. The findings may be helpful for selecting patients with coronary artery disease and left ventricular systolic dysfunction that benefit from revascularization.
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