An online search for the term "myocardial viability" yields 1,090,000 hits with Google and 4,419 (532 in 2010 and 2011 alone) citations with PubMed (both accessed on 12/24/2011). During the past 3-4 decades, viability assessment has occupied the soul and mind not only of the imaging community but also of the clinical cardiology, cardiac surgery, and basic science. It is fair to say that until the Surgical Treatment of Ischemic Heart Failure (STICH) trial viability testing was published, the debate in almost all the major national and international cardiology meetings has not been on the relevance of viability testing but rather on the comparison of one method versus another; a beauty contest of some sort! The debates between the experts in interventional cardiology, electrophysiology, nuclear cardiology, echocardiography, and magnetic resonance imaging are often heated and at times entertaining with the audience cheering one side or the other depending on the venue. Frankly this is to be expected as these dedicated individuals have spent years improving their beloved methods; anything less is hypocrisy!
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