Medical management of heart failure secondary to coronary artery disease

Radionuclide techniques for the assessment of myocardial viability and hibernation

“…47 This protocol allows assessment of viability at low dose dobutamine infusion with assessment of ischaemia at infusion of higher doses. Four patterns in regions with contractile dysfunction can be observed: (1) biphasic response-initial improvement followed by worsening of wall motion; (2) worsening-direct deterioration of wall motion without initial improvement; (3) sustained improvement-improvement of wall motion without subsequent deterioration; (4) no change-no change in wall motion during the entire study. All patterns except no change, which represents scar tissue, are related to the presence of viable myocardium.…”

“…70% of patients. 2 Currently, three routine courses of action are available: medical treatment, heart transplantation, and revascularisation. Newer therapeutic modalities include laser therapy, advanced surgery, assist devices, artificial hearts, 3 and transplantation of different (progenitor) cells.…”

Stress and tissue Doppler echocardiographic evidence of effectiveness of myoblast transplantation in patients with ischaemic heart failure

“…The clinical syndrome of heart failure has become the most prevalent cause of mortality, morbidity and hospitalisation in industrialized countries over recent years [1,2]. The incidence of HF is expected to increase in the future due to improved survival rates following acute myocardial infarction, which is the principal aetiology of heart failure in >70% of patients [3]. The mechanisms leading to heart failure following acute myocardial infarction are only partially understood [4,5], according to current understanding, a progressive decrease in the number of viable myocytes after an acute myocardial infarction could at least partially explain the transition.…”