Assessment of myocardial viability after myocardial infarction |
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Authors: | Marcelo F Di Carli |
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Institution: | (1) Division of Nuclear Medicine, Department of Radiology, and the Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 75 Francis St, Boston |
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Abstract: | Conclusions The data presented above suggest that assessment of myocardial viability after MI, particularly in those patients with severe
LV dysfunction, is important for the identification of those with the highest risk, in whom revascularization can be of clinical
benefit. There is growing and consistent evidence that patients with relatively large areas of dysfunctional but viable myocardium
after MI have improved function, symptoms, and survival with prompt revascularization compared with medical therapy alone.
Most importantly, long-term survival with revascularization in these patients is comparable with that achieved with cardiac
transplantation. There are several methods available to the clinician with which to investigate the presence of tissue viability,
and the evidence suggests that the scintigraphic approaches are the most sensitive. These observations suggest that noninvasive
investigation of the amount of ischemic myocardium should be an important component of the diagnostic evaluation of patients
with severe LV dysfunction after MI. This approach will likely enhance the often difficult process of selecting patients with
poor cardiac function in whom revascularization will likely improve both the quality and quantity of life. |
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