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Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
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Myocardial viability: heart failure perspective

Ashley Bock1, Jerry D Estep

  • 1Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Current Opinion in Cardiology
|June 25, 2019
PubMed

Insights

Assessing myocardial viability with cardiac imaging is crucial for heart failure patients with coronary artery disease (CAD). Cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) are preferred for guiding revascularization decisions.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Heart Failure Research

Background:

  • Coronary artery disease (CAD) and heart failure necessitate evaluating myocardial viability.
  • Revascularization strategies depend on the presence of viable myocardium.
  • Accurate viability assessment guides treatment decisions and improves patient outcomes.

Purpose of the Study:

  • To review and highlight various imaging modalities for assessing myocardial viability.
  • To discuss the role of imaging in guiding revascularization for patients with heart failure and CAD.
  • To compare the effectiveness of different imaging techniques in predicting outcomes post-revascularization.

Main Methods:

  • Review of current literature on cardiac imaging techniques for myocardial viability.
  • Analysis of studies utilizing cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET).
  • Examination of clinical trial data, including the PARR-2 trial, on the impact of viability testing on patient outcomes.

Main Results:

  • Cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) are effective in assessing myocardial viability.
  • Patients with residual viable myocardium after revascularization show increased mortality.
  • PET-guided viability assessment in the PARR-2 trial correlated with improved outcomes, reducing cardiac events.

Conclusions:

  • Viability testing is recommended for patients with ischemic cardiomyopathy (ICM) and suitable for revascularization.
  • Cardiovascular magnetic resonance imaging (CMR) and positron emission tomography (PET) offer superior resolution and sensitivity for viability assessment.
  • Utilizing advanced imaging modalities like CMR and PET can optimize revascularization strategies and improve patient prognosis.
Abstract

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