Revascularization in Patients With Severe Left Ventricular Dysfunction: Is the Assessment of Viability Still Viable?
Myocardial viability assessment is typically reserved for patients with coronary artery disease and significant left ventricular dysfunction. In this setting, there is myocardial adaptation to an altered physiological state that is potentially reversible. Imaging can characterize different parameters of cardiac function; however, despite previously published appraisals of different imaging modalities, there is still uncertainty regarding the role of these tests in clinical practice. The purpose of this review is to reflect on the physiological basis of myocardial viability, discuss the imaging tests available that characterize myocardial viability, and summarize the current published reports on the use of these tests in clinical practice.
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
Nandan S
NS
Anavekar
Division of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai, New York, New York.
Panithaya
P
Chareonthaitawee
Division of Cardiovascular Diseases, Icahn School of Medicine at Mount Sinai, New York, New York.
Jagat
J
Narula
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota. Electronic address: Gersh.Bernard@mayo.edu.
Bernard J
BJ
Gersh
D002470:Cell Survival / Q000502:physiology*; D002921:Cicatrix / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy; D003326:Coronary Circulation / Q000502:physiology; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D009200:Myocardial Contraction / Q000502:physiology; D017202:Myocardial Ischemia / Q000503:physiopathology; D009204:Myocardial Revascularization; D017682:Myocardial Stunning / Q000503:physiopathology; D032383:Myocytes, Cardiac / Q000502:physiology*; D011379:Prognosis; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy*
coronary artery bypass graft; coronary artery disease; myocardial hibernation; myocardial ischemia; myocardial stunning