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Multimodality Imaging of Myocardial Viability

  • Echocardiography (JM Gardin and AH Waller, Section Editors)
  • Published:
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Abstract

Purpose of Review

Myocardial viability is an important pathophysiologic concept which may have significant clinical impact in patients with left ventricular dysfunction due to ischemic heart disease. Understanding the imaging modalities used to assess viability, and the clinical implication of their findings, is critical for clinical decision-making in this population.

Recent Findings

The ability of dobutamine echocardiography, single-photon emission computed tomography, positron emission tomography, and cardiac magnetic resonance imaging to predict functional recovery following revascularization is well-established. Despite different advantages and disadvantages for each imaging modality, each modality has demonstrated reasonable performance characteristics in identifying viable myocardium. Recent data, however, has called into question whether this functional recovery leads to improved clinical outcomes.

Summary

Although the assessment of viability can be used to aid in clinical decision-making prior to revascularization, its broad application to all patients is limited by a lack of data confirming improvement in clinical outcomes. Thus, viability assessments may be best applied to select patients (such as those with increased surgical risk) and integrated with clinical, laboratory, and imaging data to guide clinical care. Future research efforts should be aimed at establishing the impact of viability on clinical outcomes.

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Authors and Affiliations

  1. Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY, 10016, USA

    Kinjan Parikh, Alana Choy-Shan & Robert Donnino

  2. Division of Cardiology, VA Harbor Medical Center, Manhattan Campus, 423 E 23rd Street, 12 West, Cardiology, New York, NY, 10010, USA

    Alana Choy-Shan & Robert Donnino

  3. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA

    Munir Ghesani

  4. Department of Radiology, New York University School of Medicine, New York, NY, 10016, USA

    Robert Donnino

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Parikh, K., Choy-Shan, A., Ghesani, M. et al. Multimodality Imaging of Myocardial Viability. Curr Cardiol Rep 23, 5 (2021). https://doi.org/10.1007/s11886-020-01433-8

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