[Detection of myocardial viability].
During or following acute or chronic coronary syndromes, marked depression of the contractile state of one or more myocardial segments may occur which is reversible after coronary flow is restored. Myocardial stunning is observed particularly following ischemia-perfusion sequences such as may occur after thrombolysis of infarction or labile angina pectoris with repeated attacks. A hibernating myocardium is seen in cases involving severe and chronic reduction of myocardial blood flow. In both situations, durable restoration of coronary blood flow can result in partial or complete correction of the kinetics of the myocardial segments involved. The biochemical mechanisms underlying these phenomena are still not fully elucidated. The detection of these phenomena is of clinical importance, since after revascularization, they can transform the contractile state of the left ventricle and, therefore, the clinical prognosis. Positron emission tomography has made it possible to understand these phenomena better, since it provides a differential analysis of coronary flow and myocardial metabolism. It cannot be used in practice, because the method is not generally available. Echography with pharmacological stimulation and isotope methods are more widely available in clinical practice and constitutes an interesting avenue of research into methods for detecting myocardial viability.
Bassand
J P
JP
Service de Cardiologie, Hôpital Universitaire Saint-Jacques, Besançon.
D000818:Animals; D002462:Cell Membrane; D002470:Cell Survival; D003327:Coronary Disease / Q000503:physiopathology; D006321:Heart / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008722:Methods; D009200:Myocardial Contraction; D017682:Myocardial Stunning / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011877:Radionuclide Imaging
Détection de la viabilité myocardique.