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Related Experiment Video

Updated: May 10, 2026

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

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

Published on: February 16, 2016

Myocardial viability and survival in ischemic left ventricular dysfunction.

Robert O Bonow¹, Gerald Maurer, Kerry L Lee

¹Center for Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Suite 1006, Chicago, IL 60611, USA. r-bonow@northwestern.edu

The New England Journal of Medicine

|April 6, 2011

Summary

Assessing myocardial viability did not identify patients who benefit from coronary-artery bypass grafting (CABG). While viable myocardium suggested better survival, this was not statistically significant after adjustments, and CABG showed no differential benefit.

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Area of Science:

Cardiology
Cardiac Surgery
Diagnostic Imaging

Background:

Myocardial viability assessment aims to identify patients with coronary artery disease and left ventricular dysfunction who may benefit from coronary-artery bypass grafting (CABG).
The clinical efficacy of using myocardial viability assessment to guide CABG decisions remains uncertain.

Purpose of the Study:

To evaluate whether the assessment of myocardial viability can identify patients with coronary artery disease and left ventricular dysfunction who experience a survival benefit from CABG compared to medical therapy alone.

Main Methods:

A substudy of the STICH trial enrolled patients with coronary artery disease and left ventricular dysfunction.
Myocardial viability was assessed using single-photon-emission computed tomography (SPECT), dobutamine echocardiography, or both.
Patients were randomized to medical therapy with or without CABG.

Main Results:

Among 601 patients with assessed myocardial viability, 298 received CABG plus medical therapy and 303 received medical therapy alone.
Patients with viable myocardium showed a trend towards lower mortality (37%) compared to those without (51%), but this was not significant after adjustment (P=0.21).
No significant interaction was found between viability status and the survival benefit of CABG (P=0.53).

Conclusions:

Myocardial viability assessment did not identify patients who would gain a differential survival benefit from CABG over medical therapy.
The presence of viable myocardium was not a significant predictor of survival benefit from CABG in this patient cohort.
Further research is needed to clarify the role of myocardial viability assessment in guiding revascularization decisions.