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Myocardial Viability
Fathima Fijula P. Manzil, MD; Paige Bennett, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        TERMINOLOGY

        • Definitions

          • Myocardial viability evaluation
            • Detection of myocardial hibernation or stunning vs. infarction in patients with ischemic cardiomyopathy
              • Myocardial hibernation
                • Chronic myocardial dysfunction due to chronically decreased myocardial perfusion
              • Myocardial stunning
                • Temporary myocardial dysfunction due to short-term underperfusion or lack of perfusion

        IMAGING

        • General Features

          • Nuclear Medicine Findings

            • Imaging Recommendations

              • Artifacts and Quality Control

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • Gross Pathologic & Surgical Features

                    • Microscopic Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                Selected References

                                1. Werner RA et al: Recent paradigm shifts in molecular cardiac imaging-Establishing precision cardiology through novel 18F-labeled PET radiotracers. Trends Cardiovasc Med. ePub, 2019
                                2. Chen K et al: PET-based imaging of ischemic heart disease. PET Clin. 14(2):211-21, 2019
                                3. Society of Nuclear Medicine and Molecular Imaging. ASNC-SCCT-SNMMI Guideline for Cardiac SPECT/CT and PET/CT 1.0. http://snmmi.files.cms-plus.com/docs/ASNC_SCCT_SNMMI%20Guideline%20for%20Cardiac%20SPECT-CT%20and%20PET-CT.pdf. Created November 15, 2012. Accessed June 2, 2019
                                4. Society of Nuclear Medicine and Molecular Imaging. ACR-SNMMI-SPR Practice Guideline for the Performance of Cardiac Scintigraphy. http://snmmi.files.cms-plus.com/docs/Cardiac_Scintigraphy_1382731812393_3.pdf. Created October 1, 2009. Accessed June 2, 2019
                                5. Arora Y et al: Impact of hibernating and viable myocardium on improvement in perfusion and left ventricular ejection fraction after coronary artery bypass graft. Nucl Med Commun. 40(4):325-32, 2019
                                6. Lang JK et al: The complexity of using resting myocardial perfusion to assess myocardial viability and predict functional recovery. J Nucl Cardiol. ePub, 2019
                                7. Hoebers LP et al: Contemporary overview and clinical perspectives of chronic total occlusions. Nat Rev Cardiol. 11(8):458-69, 2014
                                8. Sogbein OO et al: New SPECT and PET radiopharmaceuticals for imaging cardiovascular disease. Biomed Res Int. 2014:942960, 2014
                                9. Arrighi JA et al: Multimodality imaging for assessment of myocardial viability: nuclear, echocardiography, MR, and CT. Curr Cardiol Rep. 14(2):234-43, 2012
                                10. Fefer P et al: Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 59(11):991-7, 2012
                                11. Strauss HW et al. Myocardial Perfusion Imaging 3.3. SNM, 2008. http://snmmi.files.cms-plus.com/docs/Myocardial%20Perfusion%20Imaging%203.3.pdf.
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      TERMINOLOGY

                                      • Definitions

                                        • Myocardial viability evaluation
                                          • Detection of myocardial hibernation or stunning vs. infarction in patients with ischemic cardiomyopathy
                                            • Myocardial hibernation
                                              • Chronic myocardial dysfunction due to chronically decreased myocardial perfusion
                                            • Myocardial stunning
                                              • Temporary myocardial dysfunction due to short-term underperfusion or lack of perfusion

                                      IMAGING

                                      • General Features

                                        • Nuclear Medicine Findings

                                          • Imaging Recommendations

                                            • Artifacts and Quality Control

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • Gross Pathologic & Surgical Features

                                                  • Microscopic Features

                                                    CLINICAL ISSUES

                                                    • Presentation

                                                      • Demographics

                                                        • Natural History & Prognosis

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Consider

                                                              Selected References

                                                              1. Werner RA et al: Recent paradigm shifts in molecular cardiac imaging-Establishing precision cardiology through novel 18F-labeled PET radiotracers. Trends Cardiovasc Med. ePub, 2019
                                                              2. Chen K et al: PET-based imaging of ischemic heart disease. PET Clin. 14(2):211-21, 2019
                                                              3. Society of Nuclear Medicine and Molecular Imaging. ASNC-SCCT-SNMMI Guideline for Cardiac SPECT/CT and PET/CT 1.0. http://snmmi.files.cms-plus.com/docs/ASNC_SCCT_SNMMI%20Guideline%20for%20Cardiac%20SPECT-CT%20and%20PET-CT.pdf. Created November 15, 2012. Accessed June 2, 2019
                                                              4. Society of Nuclear Medicine and Molecular Imaging. ACR-SNMMI-SPR Practice Guideline for the Performance of Cardiac Scintigraphy. http://snmmi.files.cms-plus.com/docs/Cardiac_Scintigraphy_1382731812393_3.pdf. Created October 1, 2009. Accessed June 2, 2019
                                                              5. Arora Y et al: Impact of hibernating and viable myocardium on improvement in perfusion and left ventricular ejection fraction after coronary artery bypass graft. Nucl Med Commun. 40(4):325-32, 2019
                                                              6. Lang JK et al: The complexity of using resting myocardial perfusion to assess myocardial viability and predict functional recovery. J Nucl Cardiol. ePub, 2019
                                                              7. Hoebers LP et al: Contemporary overview and clinical perspectives of chronic total occlusions. Nat Rev Cardiol. 11(8):458-69, 2014
                                                              8. Sogbein OO et al: New SPECT and PET radiopharmaceuticals for imaging cardiovascular disease. Biomed Res Int. 2014:942960, 2014
                                                              9. Arrighi JA et al: Multimodality imaging for assessment of myocardial viability: nuclear, echocardiography, MR, and CT. Curr Cardiol Rep. 14(2):234-43, 2012
                                                              10. Fefer P et al: Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 59(11):991-7, 2012
                                                              11. Strauss HW et al. Myocardial Perfusion Imaging 3.3. SNM, 2008. http://snmmi.files.cms-plus.com/docs/Myocardial%20Perfusion%20Imaging%203.3.pdf.