Abstract
Background Assessment of viability in patients with ischemic cardiomyopathy (ICM) prior to possible revascularization has fallen out of favor after the STITCH trial, which failed to demonstrate a benefit of echocardiography or nuclear viability testing. CMR assessment of viability by directly visualizing the transmural extent of both viable and nonviable myocardium offers unique advantages which have not been explored in large trials. Several small studies have shown significant contractile improvement after revascularization of dysfunctional segments with residual viability by CMR. The objective of this study was to determine the prevalence of residual viability over the entire range of severity of dysfunction in patients with ICM.
Highlights
Assessment of viability in patients with ischemic cardiomyopathy (ICM) prior to possible revascularization has fallen out of favor after the STITCH trial, which failed to demonstrate a benefit of echocardiography or nuclear viability testing
CMR assessment of viability by directly visualizing the transmural extent of both viable and nonviable myocardium offers unique advantages which have not been explored in large trials
Regional contractility and transmural extent of hyperenhancement (0%, 1-25%, 2650%, 51-75%, 76-100%) were quantified using a standard seventeen-segment model
Summary
Assessment of viability in patients with ischemic cardiomyopathy (ICM) prior to possible revascularization has fallen out of favor after the STITCH trial, which failed to demonstrate a benefit of echocardiography or nuclear viability testing. CMR assessment of viability by directly visualizing the transmural extent of both viable and nonviable myocardium offers unique advantages which have not been explored in large trials. Several small studies have shown significant contractile improvement after revascularization of dysfunctional segments with residual viability by CMR.
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