Assessment of Myocardial Viability

摘要

The assessment of the distinct states of non-contractile myocardium in patients with coronary artery disease (CAD) and left ventricular (LV) dysfunction is clinically relevant, both prognostically and therapeutically [1-4]. Such dysfunction can be improved by restoring the perfusion in presence of chronic ischemia in the case of hibernating myocardium [5], or can improve spontaneously over time after an ischemic episode in the case of stunned myocardium [6]. Improvement will not occur if scarring has replaced the myocardial tissue.Pathophysiologic paradigms have emerged that describe the relationships between myocardial perfusion, metabolism and LV function, leading to these concepts of stunning and hibernation. Our understanding of these concepts is constantly changing as new data emerge, and we have much to learn with regard to the complex physiology involved in the pathogenesis of LV dysfunction, its reversal, and its relationship to patient outcome.