Practical Implications of Myocardial Viability Studies

Abstract

Many non-invasive methods, such as imaging tests, have been developed aiming to add a contribution to existing studies in estimating patients’ prognosis after myocardial injury. This prognosis is proportional to myocardial viability, which is evaluated in coronary artery disease and left ventricular dysfunction patients only.While myocardial viability represents the likelihood of a dysfunctional muscle (resulting from decreased oxygen supply for coronary artery obstruction), hibernation represents post-interventional functional recovery itself.This article proposes a review of pathophysiological basis of viability, diagnostic methods, prognosis and future perspectives of myocardial viability. An electronic bibliographic search for articles was performed in PubMed, Lilacs, Cochrane and Scielo databases, according to pre-established criteria.The studies showed the ability of many imaging techniques in detecting viable tissues in dysfunctional areas of left ventricle resulting from coronary artery injuries. These techniques can identify patients who may benefit from myocardial revascularization and indicate the most appropriate treatment.

Prospects for Raman spectroscopy in cardiology

“…Оценка жизнеспособности миокарда является важной проблемой в определении объема хирургического вмешательства у пациентов с хронической сердечной недостаточностью после ИМ [40]. Непосредственно до операции для оценки состояния миокарда могут проводиться: компьютерная томография, магнитно-резонансная томография, радиоизотопная визуализация и эхокардиография [41,42]. Цель данных исследований определить, имеет ли ишемизированный миокард потенциал для восстановления сократительных функций после возобновления коронарного кровообращения [41,42].…”

“…Непосредственно до операции для оценки состояния миокарда могут проводиться: компьютерная томография, магнитно-резонансная томография, радиоизотопная визуализация и эхокардиография [41,42]. Цель данных исследований определить, имеет ли ишемизированный миокард потенциал для восстановления сократительных функций после возобновления коронарного кровообращения [41,42]. Однако перечисленные диагностические методы не являются достаточно информативными ввиду относительно слабой регионарной корреляции с интраоперационными данными, полученными под непосредственным контролем зрения.…”

Imagem Cardiovascular em Pacientes com COVID-19

“…Em resumo, a medicina nuclear é fundamental para o manejo de doenças cardiovasculares. [7][8][9][10][11] na cardiologia clínica de rotina, mas não é a primeira linha de abordagem para pacientes com COVID-19. Apesar disso, seus procedimentos podem eventualmente ajudar no manejo desses pacientes.…”

The Current Role of Viability Imaging to Guide Revascularization and Therapy Decisions in Patients With Heart Failure and Reduced Left Ventricular Function

“…Based on post-hoc analyses and observational data, viability imaging may contribute to risk stratification and selection of patients considered eligible for myocardial revascularization. (3,4,16,(18)(19)(20)28,53) GDMT includes: optimal pharmacological and non-pharmacological therapy for all patients and implantable device therapy for appropriately selected patients, as key therapies for IHF patients. The selection for percutaneous mitral valve procedures is still in evolution.…”

“…(25,27,29,32,56) Post-hoc RCT and observational data suggest that this may be in particular for those with high ischemic burden and viable myocardium and/or low scar burden. (3,4,16,(18)(19)(20)28,53,56) Other potentially useful parameters to guide therapeutic strategies include remodelling, LV ejection fraction, right ventricular failure, pulmonary hypertension, mitral or tricuspid regurgitation as well as duration of cardiac dysfunction as suggested by Bax et al and others. (53,57) However the intersection and application of these complex parameters into a clinical decision remains a challenge.…”