[Assessment of myocardial viability in postinfarction and indications of revascularization].
Following myocardial infarction, it is indispensable to investigate the viability of the myocardium when signs of left ventricular dysfunction are predominant, so as to distinguish between permanent ventricular dysfunction and dysfunction that can be improved with treatment. Several imaging techniques are capable of detecting viable hibernating myocardium; each addresses a specific aspect of the problem. Stress echocardiography and nuclear imaging techniques remain the most widely used even though new techniques like MRI may be better for detecting myocardial viability. Remote myocardial revascularization can lead to regression of the remodeling of the left ventricle, which occurs after infarction causing latent or patent cardiac failure, and thus to recovery of left ventricular function. It is therefore indicated, in association with optimal medical treatment, in patients selected by viability explorations. The best revascularization method (angioplasty or surgery) should be proposed according to scientific knowledge, the comorbidities, and the patient's choice.
Zouaoui
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W
Service de cardiologie B, fédération de cardiologie, hôpital de Rangueil, CHU de Toulouse, 1, avenue Jean-Poulhès, 31059 Toulouse cedex 9, France.
Ouldzein
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H
Carrié
D
D
D003952:Diagnostic Imaging / Q000379:methods; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods*; D017682:Myocardial Stunning / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D009206:Myocardium / Q000473:pathology*; D014022:Tissue Survival / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D020257:Ventricular Remodeling / Q000502:physiology