PMID: 8590746Oct 1, 1995Paper

Assessing myocardial viability to help select patients for revascularization to improve left ventricular dysfunction due to coronary artery disease

Seminars in Thoracic and Cardiovascular Surgery
R E Patterson, W C Pilcher

Abstract

Left ventricular dysfunction has become one of the most common causes of death, disability, and health care costs. Left ventricular dysfunction is usually due to coronary artery disease (CAD) and can be improved considerably by successful revascularization in many, but not all, patients. The key issue determining whether revascularization will relieve left ventricular dysfunction is whether the patient has enough viable myocardium to improve after revascularization. Viable myocardium is located anatomically in the subepicardial layers of the left ventricular wall, above the infarct in the subendocardial layers in the distribution of a stenotic coronary artery. Clinical history, physical examination, resting or exercise ECG, and imaging studies of left ventricular function often fail to distinguish patients with viable myocardium. Thallium-201 myocardial imaging at stress and rest is better if performed with reinjection of thallium-201 at rest, but this method still misses many patients with viable myocardium. Positron emission tomographic (PET) myocardial imaging to compare distributions of a perfusion tracer versus a metabolic tracer (fluorine-18-fluoro-deoxyglucose, 18FDG) has been cited as the "gold standard" method to ident...Continue Reading

Related Concepts

Related Feeds

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.