Diagnosis of myocardial viability in chronic myocardial ischemia with nuclear medicine techniques

Abstract

Non-invasive methods to identify absent or persistent myocardial viability have gained increasing importance in the therapeutic management and risk stratification of patients with ischemic left ventricular dysfunction. Myocardial scintigraphy using thallium-201 and positron emission tomography with metabolic imaging of myocardial glucose metabolism, using fluorine-18 fluoro-deoxyglucose, are today the most widely used nuclear methods for the assessment of myocardial viability. Besides the prediction of reversible regional and global myocardial dysfunction following coronary revascularization, both methods have demonstrated the ability to identify patient subgroups who will benefit most with regard to cardiac prognosis and survival and those patients in whom coronary revascularization has a limited effect with regard to survival and cardiac events. This short review summarizes the clinical impact of both imaging modalities on today's diagnostic approach in patients with ischemic left ventricular dysfunction.