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International Journal of Radiology & Medical Imaging Volume 2 (2016), Article ID 2:IJRMI-110, 10 pages
https://doi.org/10.15344/2456-446X/2016/110
Review Article
Myocardial Viability Assessment is Still Alive and an Important Element in Predicting Prognosis and Providing Optimal Management for Ischemic Heart Failure

Tokuo Kasai

Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji Tokyo 193-0998, Japan
Dr. Tokuo Kasai, Department of Cardiology, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji Tokyo 193- 0998, Japan, Tel: +81-42-665-5611; E-mail: tkkasai@tokyo-med.ac.jp
06 January 2016; 05 March 2016; 08 March 2016
Kasai T (2016) Myocardial Viability Assessment is Still Alive and an Important Element in Predicting Prognosis and Providing Optimal Management for Ischemic Heart Failure. Int J Radiol Med Imag 2: 110. doi: https://doi.org/10.15344/2456-446X/2016/110

Abstract

Chronic heart failure is posing medical and socio-economicburden with a high prevalence, high rehospitalization rate, and high mortality. It consumes huge cost, including direct/indirect medical cost, and needs multidisciplinary medical staffs. In addition, its prevalence and cost are growing now and towards the future. Heart failure is an entity of clinical syndrome, including various etiology, such as ischemic heart disease, valvular heart disease, cardiomyopathies, and so on. Therefore, comprehensive understanding of pathophysiological status in each patient is essential to provide optimal therapy. From this point of view, non-invasive cardiac imaging including echocardiography, magnetic resonance imaging, multi-detector computed tomography, and nuclear imaging play a crucial role to assess anatomy and function. Some of them provide pathophysiological information underlying heart failure. The imaging modalities should be selected based on what kind of information is needed to manage each patient: etiology (ischemic/non-ischemic), function (reduced/preserved ejection fraction and dyssynchrony), complications (mitral regurgitation and fatal arrhythmias). In patients with ischemic cardiomyopathy, advanced heart failure, and fatal arrhythmias, indication for revascularization, cardiac resynchronization therapy, and implantable cardiac defibrillator should be evaluated, respectively. Myocardial viability has been regarded as prerequisite for revascularization. However, it is controversial after The Surgical Treatment for Ischemic Heart Failure (STICH) trial. This review focus on the myocardial viability and discuss some issues concerning assessment of myocardial viability.