Multimodality imaging in the assessment of myocardial viability

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10:46

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Published on: December 19, 2013

Sara L Partington1, Raymond Y Kwong, Sharmila Dorbala

  • 1Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology), Brigham and Women's Hospital, 70 Francis Street, Floor 5, Room 128, Boston, MA 02115, USA.

Heart Failure Reviews
|November 12, 2010
PubMed

Insights

Assessing myocardial viability is crucial for heart failure patients with coronary artery disease. This review compares imaging techniques to guide optimal patient selection for revascularization, improving outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Heart Failure Research

Background:

  • Heart failure due to coronary artery disease (CAD) is increasing and has a poorer prognosis than non-ischemic cardiomyopathy.
  • Revascularization benefits high-risk CAD patients with viable myocardium, making accurate viability assessment essential.
  • Differentiating viable heart muscle from scar in dysfunctional areas is key for treatment decisions.

Purpose of the Study:

  • To review the physiology of myocardial hibernation and stunning.
  • To comprehensively review current imaging modalities for assessing myocardial viability.
  • To compare the effectiveness and limitations of various viability assessment techniques.

Main Methods:

  • Review of existing literature on myocardial viability assessment.
  • Detailed examination of echocardiography, cardiac magnetic resonance imaging (CMR), nuclear imaging (SPECT, PET), and cardiac computed tomography (CCT).
  • Comparative analysis of the diagnostic performance and clinical utility of each modality.

Main Results:

  • Multiple imaging modalities can differentiate viable myocardium from scar.
  • Each technique possesses unique strengths and limitations in assessing myocardial viability.
  • Evidence suggests revascularization improves prognosis in selected viable myocardium patients.

Conclusions:

  • Optimal assessment of myocardial viability is critical for managing heart failure patients with CAD.
  • Choosing the most appropriate imaging modality depends on individual patient factors and clinical context.
  • Further research is needed to refine techniques and establish definitive guidelines for viability assessment.

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