Alexanderson RE

Language: Spanish
References: 10
Page: 9-13
PDF size: 54.50 Kb.

ABSTRACT

The goal of myocardial viability assessment is to differentiate, prospectively, patients with potentially reversible from irreversible left ventricular dysfunction. Ideally, this information should be used to guide therapeutic decisions for revascularization. Therapeutic interventions that improve non functioning but viable myocardial regions may improve significantly global left ventricular function as well as impact left ventricular dysfunction, in which revascularization entails high perioperative morbidity and mortality. Accurate assessment of myocardial viability may result in more appropriate utilization of resources and enhance efficiency in health care delivery. Myocardial viability can be valorated with perfusion images using dual metod or tallium reinjection, isotopic ventriculography, Gated SPECT with dobutamine stress or cardiac metabolism with PET.

REFERENCES

1. Dilsizian S: Myocardial viability: a clinical and scientific treatise 1st. Ed. New York USA. Futura publishing company, 2000.

2. Christian TF, Miller TD, Hosdge DO, et al: An estimate of the prevalence of reversible left ventricular dysfunction in patients referred for coronary artery bypass surgery. J Nucl Cardiol 1997; 4: 140-146

3. Depre C, Vanovershelde JJ, Melin JA, et al: Structural and metabolic correlates of the reversibility of chronic left ventricular ischemic dysfunction in humans. An J Phisiol 1995; 268: H1265-H1275.

4. Vanov JL, Woijns W, Borgers M, et al: Chronic myocardial hibernation in humans: From bedside to bench. Circulation 1997; 95: 1961-1971.

5. Borgers M, Ausma J: Structural aspects of chronic hibernanting myocardium in the man. Basic Res Cardiol 1995; 90: 44-46.

6. Elsasser A, Schepper M, Klovekorn WP, et al: Hibernating myocardium: An incomplete adaptation to ischemia. Circulation 1997; 96: 2920-2931.

7. Zaret BL, Beller GA: Nuclear Cardiology. State of the art and future directions. 2nd ed. Mosby, Boston, 1999.

8. Alexanderson E, Villarreal O, Unzek S, et al: Assessment of myocardial viability and prognosis using low dose dobutamine gated SPECT in patients with myocardial infarction. (Abstr) J Nucl Cardiol (Suppl) 2000; 8: S47.

9. Von Schulthess GK: Clinical Positron emission tomography. 1ª ed. Lippincott Williams and Wilkins, Philadelphia, 2000.

10. Muzik O, Duvernoy C, Beanlands RS: Assessment of diagnostic performance of quantitative flow measurements in normal subjects and patients with angiographically documented coronary artery disease by means of nitrogen-13 ammonia and positron emission tomography. J Am Coll Cardiol 1998; 31: 534-50.