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Imaging and Intervention in Cardiology pp 279–292Cite as

Assessment of viability in severely hypokinetic myocardium before revascularization and prediction of functional recovery: The role of echocardiography

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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 173))

Abstract

Since the last decade, it is well established that persistent, severe myocardial dysfunction in patients with coronary artery disease does not always indicate myocardial necrosis and irreversible damage. The differentiation between viable and non viable tissue is thus of great clinical relevance in order to take an appropriate decision in the individual patient. Akinetic but viable myocardium may correspond to several different states that are important but difficult to be distinguished. The concepts of stunning and hibernation have been introduced [1, 2]; the terms are increasingly used; knowledge about their respective mechanisms has largely improved [3, 4] and several techniques have been studied for their identification [5]. These techniques can assess regional perfusion, membrane integrity, metabolism or contractility. There are several important questions to be answered in the clinical environment: Does this patient have viable myocardium? What is the extent of viable tissue? Does this patient require a revascularization procedure to improve his segmental function? Can I quantitatively predict the amount of functional recovery? What are the relative risks/benefits of the different therapeutic approaches? The answers to these questions are particularly crucial when global left ventricular function is severely depressed.

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Author information

Authors and Affiliations

  1. Service de Cardiologie, CHU du Sart Tilman, B-4000, Liege, Belgium

    Dr Luc A. Pierard

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  1. Dr Luc A. Pierard
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Editors and Affiliations

  1. Department of Cardiology, University Hospital Eppendorf, Martinistrasse 52, D-20246, Hamburg, Germany

    Christoph A. Nienaber

  2. Klinik III für Innere Medizin, University of Cologne, Joseph-Stelzmannstrasse 9, D-50924, Cologne, Germany

    Udo Sechtem

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© 1996 Kluwer Academic Publishers

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Pierard, L.A. (1996). Assessment of viability in severely hypokinetic myocardium before revascularization and prediction of functional recovery: The role of echocardiography. In: Nienaber, C.A., Sechtem, U. (eds) Imaging and Intervention in Cardiology. Developments in Cardiovascular Medicine, vol 173. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-0115-5_18

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  • DOI: https://doi.org/10.1007/978-94-009-0115-5_18

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6538-2

  • Online ISBN: 978-94-009-0115-5

  • eBook Packages: Springer Book Archive

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