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Assessment of myocardial viability with two-dimensional echocardiography and magnetic resonance imaging
1Cardiovascular Division, University of Virginia School of Medicine, Charlottesville 22908, USA.
Insights
Assessing myocardial viability in coronary artery disease patients is challenging. Cardiac imaging techniques like echocardiography and MRI help determine viable heart tissue and guide treatment strategies.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Clinical, electrocardiographic, and angiographic data are often insufficient for assessing myocardial viability in coronary artery disease (CAD).
- Myocardial dysfunction in CAD can be multifactorial, affecting single or multiple myocardial segments.
- Identifying viable myocardium is crucial for optimizing patient management strategies.
Purpose of the Study:
- To review the utility of cardiac imaging techniques in assessing myocardial viability.
- To discuss the role of two-dimensional echocardiography and magnetic resonance imaging in evaluating viable myocardial tissue.
Main Methods:
- Review of existing literature on cardiac imaging for myocardial viability assessment.
- Focus on two-dimensional echocardiography and magnetic resonance imaging.
Main Results:
- Wall thickening, even if reduced, is a reliable indicator of myocardial viability.
- Absence of wall thickening does not definitively rule out myocardial viability.
- Cardiac imaging effectively elucidates mechanisms of myocardial dysfunction.
Conclusions:
- Two-dimensional echocardiography and magnetic resonance imaging are valuable tools for assessing myocardial viability in CAD patients.
- These imaging modalities aid in understanding the causes of myocardial dysfunction.
- Accurate viability assessment assists in selecting optimal management strategies for patients with coronary artery disease.
Abstract:
In a patient with coronary artery disease, clinical, electrocardiographic, and angiographic information is often inadequate for determining the presence of viable tissue. The presence of wall thickening, even if reduced, indicates that the myocardium is viable. When wall thickening is absent, the myocardium may or may not be viable. The basis for the underlying myocardial dysfunction may be multifactorial in a single patient or even in a single myocardial segment. Cardiac imaging techniques are most useful in defining the mechanisms of underlying myocardial dysfunction and assist in selecting the optimal management strategy for patients. This review discusses the role of two-dimensional echocardiography and magnetic resonance imaging for the assessment of myocardial viability.