Myocardial Viability

  • Won Jun Kang


Ischemic heart disease is the most common cause of heart failure. For the treatment of heart failure, medical treatment, heart transplantation, and revascularization can be a therapeutic method (Challapalli S, Bonow RO, Gheorghiade M. Coron Artery Dis 9:659–674, 1998). Because of the ease of the procedure and good therapeutic performance, revascularization has been widely used in ischemic heart disease (Alderman EL, Corley SD, Fisher LD, Chaitman BR, Faxon DP, Foster ED, Killip T, Sosa JA, Bourassa MG. J Am Coll Cardiol 22(4):1141–1154, 1993). However, revascularization has a substantial degree of risk associated with the procedure, especially in patients with severe heart failure, and heart function is recovered only in some of the patients who undergo revascularization (Schinkel AF, Poldermans D, Vanoverschelde JL, Elhendy A, Boersma E, Roelandt JR, et al. Am J Cardiol 93:14–17, 2004).


Myocardial Perfusion Viable Myocardium Myocardial Perfusion SPECT Myocardial SPECT Rest Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Challapalli S, Bonow RO, Gheorghiade M. Medical management of heart failure secondary to coronary artery disease. Coron Artery Dis. 1998;9:659–74.PubMedGoogle Scholar
  2. 2.
    Alderman EL, Corley SD, Fisher LD, Chaitman BR, Faxon DP, Foster ED, Killip T, Sosa JA, Bourassa MG. Five-year angiographic follow-up of factors associated with progression of coronary artery disease in the Coronary Artery Surgery Study (CASS) CASS Participating Investigators and Staff. J Am Coll Cardiol. 1993;22(4):1141–54.PubMedCrossRefGoogle Scholar
  3. 3.
    Schinkel AF, Poldermans D, Vanoverschelde JL, Elhendy A, Boersma E, Roelandt JR, et al. Incidence of recovery of contractile function following revascularization in patients with ischemic left ventricular dysfunction. Am J Cardiol. 2004;93:14–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Maes A, Flameng W, Nuyts J, Borgers M, Shivalkar B, Ausma J, et al. Histological alterations in chronically hypoperfused myocardium. Correlation with PET findings. Circulation. 1994;90:735–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Rahimtoola SH. The hibernating myocardium. Am Heart J. 1989;117:211–21.PubMedCrossRefGoogle Scholar
  6. 6.
    Braunwald E, Kloner RA. The stunned myocardium: prolonged, postischemic ventricular dysfunction. Circulation. 1982;66:1146–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Bolli R. Myocardial ‘stunning’ in man. Circulation. 1992;86(6):1671–91.PubMedCrossRefGoogle Scholar
  8. 8.
    Vanoverschelde JL, Melin JA. The pathophysiology of myocardial hibernation: current controversies and future directions. Prog Cardiovasc Dis. 2001;43:387–98.PubMedCrossRefGoogle Scholar
  9. 9.
    Bax JJ, van der Wall EE, Harbinson M. Radionuclide techniques for the assessment of myocardial viability and hibernation. Heart. 2004;90(Suppl 5):v26–33.PubMedCrossRefGoogle Scholar
  10. 10.
    Bax JJ, Poldermans D, Elhendy A, Boersma E, Rahimtoola SH. Sensitivity, specificity, and predictive accuracies of various noninvasive techniques for detecting hibernating myocardium. Curr Probl Cardiol. 2001;26:147–86.PubMedCrossRefGoogle Scholar
  11. 11.
    Bax JJ, Maddahi J, Poldermans D, Elhendy A, Cornel JH, Boersma E, et al. Sequential (201)Tl imaging and dobutamine echocardiography to enhance accuracy of predicting improved left ventricular ejection fraction after revascularization. J Nucl Med. 2002;43(6):795–802.PubMedGoogle Scholar
  12. 12.
    Samady H, Elefteriades JA, Abbott BG, Mattera JA, McPherson CA, Wackers FJ. Failure to improve left ventricular function after coronary revascularization for ischemic cardiomyopathy is not associated with worse outcome. Circulation. 1999;100:1298–304.PubMedCrossRefGoogle Scholar
  13. 13.
    Marwick TH, Zuchowski C, Lauer MS, Secknus MA, Williams J, Lytle BW. Functional status and quality of life in patients with heart failure undergoing coronary bypass surgery after assessment of myocardial viability. J Am Coll Cardiol. 1999;33:750–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Dilsizian V, Bonow RO. Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation. 1993;87:1–20.PubMedCrossRefGoogle Scholar
  15. 15.
    Bonow RO, Dilsizian V. Thallium-201 and technetium-99 m-sestamibi for assessing viable myocardium. J Nucl Med. 1992;33:815–8.PubMedGoogle Scholar
  16. 16.
    Sciagrà R, Pellegri M, Pupi A, Bolognese L, Bisi G, Carnovale V, Santoro GM. Prognostic implications of Tc-99 m sestamibi viability imaging and subsequent therapeutic strategy in patients with chronic coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol. 2000;36:739–45.PubMedCrossRefGoogle Scholar
  17. 17.
    King LM, Opie LH. Glucose delivery is a major determinant of glucose utilisation in the ischemic myocardium with a residual coronary flow. Cardiovasc Res. 1998;39:381–92.PubMedCrossRefGoogle Scholar
  18. 18.
    Gropler RJ. Methodology governing the assessment of myocardial glucose metabolism by positron emission tomography and fluorine 18-labeled fluorodeoxyglucose. J Nucl Cardiol. 1994;1:S4–14.PubMedCrossRefGoogle Scholar
  19. 19.
    Knuuti MJ, Yki-Järvinen H, Voipio-Pulkki LM, Mäki M, Ruotsalainen U, Härkönen R, et al. Enhancement of myocardial [fluorine-18]fluorodeoxyglucose uptake by a nicotinic acid derivative. J Nucl Med. 1994;35:989–98.PubMedGoogle Scholar
  20. 20.
    Bax JJ, Patton JA, Poldermans D, Elhendy A, Sandler MP. 18-Fluorodeoxyglucose imaging with positron emission tomography and single photon emission computed tomography: cardiac applications. Semin Nucl Med. 2000;30:281–98.PubMedCrossRefGoogle Scholar
  21. 21.
    Di Carli MF, Davidson M, Little R, Khanna S, Mody FV, Brunken RC, et al. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1994;73:527–33.PubMedCrossRefGoogle Scholar
  22. 22.
    Maddahi J, Schelbert H, Brunken R, Di Carli M. Role of thallium-201 and PET imaging in evaluation of myocardial viability and management of patients with coronary artery disease and left ventricular dysfunction. J Nucl Med. 1994;35:707–15.PubMedGoogle Scholar
  23. 23.
    Allman KC, Shaw LJ, Hachamovitch R, Udelson JE. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol. 2002;39:1151–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Nuclear Medicine, Department of Nuclear MedicineYonsei University, Severance HospitalSeoulSouth Korea

Personalised recommendations