Preserved myocardial viability and recurrent symptomatic ischemia are the most widely accepted criteria indicating that coronary revascularization should take place in patients with postischemic left ventricular dysfunction. However, the presence of viable myocardium within the infarct zone does not necessarily imply recovery of function after coronary revascularization. The complex relation between the extent of transmural necrosis and the degree of residual perfusion within the infarct area plays an important role. However, independently of functional recovery, cell viability may have important clinical implications, since it may improve long-term prognosis by attenuating left ventricular remodeling processes. Several different methods are used to detect hibernating myocardium. Mounting evidence suggests that thallium-201 scintigraphy is most sensitive in identifying tissue viability, whereas dobutamine echocardiography is most specific in predicting functional recovery after revascularization, In between, myocardial contrast echocardiography is the only technique able to evaluate the microvascular integrity that is a condition sine qua non for both cell viability and later functional recovery. Combined information derived from these 3 different approaches might be considered as the best way to understand how the combination of contractile, viable but noncontractile, and dead tissue affect resultant function and prognosis. (C) 1998 by Excerpta Medica, Inc.
The complex relation between myocardial viability and functional recovery in chronic left ventricular dysfunction / Agati, Luciano; Autore, Camillo; Iacoboni, Carlo; Monica, Castaldo; Veneroso, Gabriele; Paolo, Voci; Fedele, Francesco; Armando, Dagianti. - In: THE AMERICAN JOURNAL OF CARDIOLOGY. - ISSN 0002-9149. - ELETTRONICO. - 81:12 A(1998), pp. 33G-35G. (Intervento presentato al convegno 9th International Congress on Echocardiography - Clinical Cardiology tenutosi a ROME, ITALY nel FEB 05-08, 1997) [10.1016/s0002-9149(98)00051-4].
The complex relation between myocardial viability and functional recovery in chronic left ventricular dysfunction
AGATI, Luciano;AUTORE, Camillo;IACOBONI, Carlo;VENEROSO, Gabriele;FEDELE, Francesco;
1998
Abstract
Preserved myocardial viability and recurrent symptomatic ischemia are the most widely accepted criteria indicating that coronary revascularization should take place in patients with postischemic left ventricular dysfunction. However, the presence of viable myocardium within the infarct zone does not necessarily imply recovery of function after coronary revascularization. The complex relation between the extent of transmural necrosis and the degree of residual perfusion within the infarct area plays an important role. However, independently of functional recovery, cell viability may have important clinical implications, since it may improve long-term prognosis by attenuating left ventricular remodeling processes. Several different methods are used to detect hibernating myocardium. Mounting evidence suggests that thallium-201 scintigraphy is most sensitive in identifying tissue viability, whereas dobutamine echocardiography is most specific in predicting functional recovery after revascularization, In between, myocardial contrast echocardiography is the only technique able to evaluate the microvascular integrity that is a condition sine qua non for both cell viability and later functional recovery. Combined information derived from these 3 different approaches might be considered as the best way to understand how the combination of contractile, viable but noncontractile, and dead tissue affect resultant function and prognosis. (C) 1998 by Excerpta Medica, Inc.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.