Multimodality imaging in the assessment of myocardial viability.
The prevalence of heart failure due to coronary artery disease continues to increase, and it portends a worse prognosis than non-ischemic cardiomyopathy. Revascularization improves prognosis in these high-risk patients who have evidence of viability; therefore, optimal assessment of myocardial viability remains essential. Multiple imaging modalities exist for differentiating viable myocardium from scar in territories with contractile dysfunction. Given the multiple modalities available, choosing the best modality for a specific patient can be a daunting task. In this review, the physiology of myocardial hibernation and stunning will be reviewed. All the current methods available for assessing viability including echocardiography, cardiac magnetic resonance imaging, nuclear imaging with single photon emission tomography and positron emission tomography imaging and cardiac computed tomography will be reviewed. The effectiveness of the various techniques will be compared, and the limitations of the current literature will be discussed.
Noninvasive Cardiovascular Imaging Program, Departments of Medicine (Cardiology), Brigham and Women's Hospital, 70 Francis Street, Floor 5, Room 128, Boston, MA 02115, USA.
Sara L
SL
Partington
Raymond Y
RY
Kwong
Sharmila
S
Dorbala
D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D009682:Magnetic Resonance Spectroscopy; D009204:Myocardial Revascularization; D017682:Myocardial Stunning / Q000175:diagnosis / Q000000981:diagnostic imaging; D009206:Myocardium / Q000473:pathology*; D049268:Positron-Emission Tomography; D011859:Radiography; D014022:Tissue Survival; D015899:Tomography, Emission-Computed, Single-Photon