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. 2004 Aug;90(Suppl 5):v26–v33. doi: 10.1136/hrt.2002.007575

Radionuclide techniques for the assessment of myocardial viability and hibernation

J Bax, E E van der Wall, M Harbinson
PMCID: PMC1876321  PMID: 15254006

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Figure 1.

Figure 1

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 Changes in left ventricular ejection fraction (LVEF), observed in 47 patients with ischaemic cardiomyopathy undergoing revascularisation. Improvement in LVEF was defined as an increase in LVEF of ⩾ 5% after revascularisation. (Data based on Bax and colleagues.13)

Figure 2.

Figure 2

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 Bar graph illustrating the influence of FDG PET imaging on subsequent patient management. The grey bars indicate the number of patients and their planned treatment before FDG PET was performed; the white bars demonstrate the number of patients in whom treatment was changed according to the FDG PET results. HTX, heart transplantation; Med, medical treatment; Rev, revascularisation. (Reprinted from Bax and colleagues,44 with permission).

Figure 3.

Figure 3

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 Bar graphs indicating the discrepancy between contractile reserve (assessed by DSE) and different nuclear imaging techniques. CR+, contractile reserve present; CR–, contractile reserve absent; DSE, dobutamine stress echocardiography; FDG, F18-fluorodeoxyglucose; FFA, free fatty acids. (Based on Sloof and colleagues.33)

Figure 4.

Figure 4

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 Sensitivity and specificity of the various viability techniques to predict improvement of regional left ventricular function after revascularisation. DSE, dobutamine stress echocardiography; FDG, F18-fluorodeoxyglucose; MIBI, sestamibi; Tl-201 RI, thallium-201 reinjection; Tl-201 RR, thallium-201 rest-redistribution. (Data based on Bax and colleagues.26)

Figure 5.

Figure 5

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 Sensitivity and specificity of dobutamine stress echocardiography (DSE) and nuclear imaging (Nuclear) techniques (based on pooled data from 11 studies (n = 325 patients) that performed a direct comparison between DSE and nuclear imaging to predict improvement in regional LV function after revascularisation). The sensitivity of the nuclear techniques was significantly higher as compared to DSE, whereas the specificity of DSE was significantly higher. (Data based on Bax and colleagues.26)

Figure 6.

Figure 6

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 Prognostic value of the viability studies: event rate is plotted versus presence/absence of viability and treatment (medical/revascularisation). The highest mortality is observed in the patients with viable myocardium who were treated medically. Med: medical treatment; Revasc: revascularisation. (Based on pooled data from references 47, 48, 61–75.)

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Afridi I., Grayburn P. A., Panza J. A., Oh J. K., Zoghbi W. A., Marwick T. H. Myocardial viability during dobutamine echocardiography predicts survival in patients with coronary artery disease and severe left ventricular systolic dysfunction. J Am Coll Cardiol. 1998 Oct;32(4):921–926. doi: 10.1016/s0735-1097(98)00321-0. [DOI] [PubMed] [Google Scholar]
  2. Auerbach M. A., Schöder H., Hoh C., Gambhir S. S., Yaghoubi S., Sayre J. W., Silverman D., Phelps M. E., Schelbert H. R., Czernin J. Prevalence of myocardial viability as detected by positron emission tomography in patients with ischemic cardiomyopathy. Circulation. 1999 Jun 8;99(22):2921–2926. doi: 10.1161/01.cir.99.22.2921. [DOI] [PubMed] [Google Scholar]
  3. Baer F. M., Theissen P., Schneider C. A., Voth E., Sechtem U., Schicha H., Erdmann E. Dobutamine magnetic resonance imaging predicts contractile recovery of chronically dysfunctional myocardium after successful revascularization. J Am Coll Cardiol. 1998 Apr;31(5):1040–1048. doi: 10.1016/s0735-1097(98)00032-1. [DOI] [PubMed] [Google Scholar]
  4. Baer F. M., Voth E., Schneider C. A., Theissen P., Schicha H., Sechtem U. Comparison of low-dose dobutamine-gradient-echo magnetic resonance imaging and positron emission tomography with [18F]fluorodeoxyglucose in patients with chronic coronary artery disease. A functional and morphological approach to the detection of residual myocardial viability. Circulation. 1995 Feb 15;91(4):1006–1015. doi: 10.1161/01.cir.91.4.1006. [DOI] [PubMed] [Google Scholar]
  5. Baker D. W., Jones R., Hodges J., Massie B. M., Konstam M. A., Rose E. A. Management of heart failure. III. The role of revascularization in the treatment of patients with moderate or severe left ventricular systolic dysfunction. JAMA. 1994 Nov 16;272(19):1528–1534. doi: 10.1001/jama.272.19.1528. [DOI] [PubMed] [Google Scholar]
  6. Baumgartner H., Porenta G., Lau Y. K., Wutte M., Klaar U., Mehrabi M., Siegel R. J., Czernin J., Laufer G., Sochor H. Assessment of myocardial viability by dobutamine echocardiography, positron emission tomography and thallium-201 SPECT: correlation with histopathology in explanted hearts. J Am Coll Cardiol. 1998 Nov 15;32(6):1701–1708. doi: 10.1016/s0735-1097(98)00436-7. [DOI] [PubMed] [Google Scholar]
  7. Bax J. J., Patton J. A., Poldermans D., Elhendy A., Sandler M. P. 18-Fluorodeoxyglucose imaging with positron emission tomography and single photon emission computed tomography: cardiac applications. Semin Nucl Med. 2000 Oct;30(4):281–298. doi: 10.1053/snuc.2000.9543. [DOI] [PubMed] [Google Scholar]
  8. Bax J. J., Poldermans D., Elhendy A., Cornel J. H., Boersma E., Rambaldi R., Roelandt J. R., Fioretti P. M. Improvement of left ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography. J Am Coll Cardiol. 1999 Jul;34(1):163–169. doi: 10.1016/s0735-1097(99)00157-6. [DOI] [PubMed] [Google Scholar]
  9. Bax J. J., Visser F. C., Poldermans D., Elhendy A., Cornel J. H., Boersma E., Valkema R., Van Lingen A., Fioretti P. M., Visser C. A. Relationship between preoperative viability and postoperative improvement in LVEF and heart failure symptoms. J Nucl Med. 2001 Jan;42(1):79–86. [PubMed] [Google Scholar]
  10. Bax J. J., Visser F. C., Poldermans D., Elhendy A., Cornel J. H., Boersma E., van Lingen A., Fioretti P. M., Visser C. A. Time course of functional recovery of stunned and hibernating segments after surgical revascularization. Circulation. 2001 Sep 18;104(12 Suppl 1):I314–I318. doi: 10.1161/hc37t1.094853. [DOI] [PubMed] [Google Scholar]
  11. Bax J. J., van Eck-Smit B. L., van der Wall E. E. Assessment of tissue viability: clinical demand and problems. Eur Heart J. 1998 Jun;19(6):847–858. doi: 10.1053/euhj.1997.0765. [DOI] [PubMed] [Google Scholar]
  12. Bax Jeroen J., Maddahi Jamshid, Poldermans Don, Elhendy Abdou, Cornel Jan H., Boersma Eric, Roelandt Jos R. T. C., Fioretti Paolo M. Sequential (201)Tl imaging and dobutamine echocardiography to enhance accuracy of predicting improved left ventricular ejection fraction after revascularization. J Nucl Med. 2002 Jun;43(6):795–802. [PubMed] [Google Scholar]
  13. Bax Jeroen J., Poldermans Don, Schinkel Arend F. L., Boersma Eric, Elhendy Abdou, Maat Alexander, Valkema Roelf, Krenning Eric P., Roelandt Jos R. T. C. Perfusion and contractile reserve in chronic dysfunctional myocardium: relation to functional outcome after surgical revascularization. Circulation. 2002 Sep 24;106(12 Suppl 1):I14–I18. [PubMed] [Google Scholar]
  14. Beanlands R. S., Hendry P. J., Masters R. G., deKemp R. A., Woodend K., Ruddy T. D. Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fluorodeoxyglucose positron emission tomography imaging. Circulation. 1998 Nov 10;98(19 Suppl):II51–II56. [PubMed] [Google Scholar]
  15. Beanlands R. S., deKemp R. A., Smith S., Johansen H., Ruddy T. D. F-18-fluorodeoxyglucose PET imaging alters clinical decision making in patients with impaired ventricular function. Am J Cardiol. 1997 Apr 15;79(8):1092–1095. doi: 10.1016/s0002-9149(97)00054-4. [DOI] [PubMed] [Google Scholar]
  16. Bonow R. O., Dilsizian V. Thallium-201 and technetium-99m-sestamibi for assessing viable myocardium. J Nucl Med. 1992 May;33(5):815–818. [PubMed] [Google Scholar]
  17. Bonow R. O. Identification of viable myocardium. Circulation. 1996 Dec 1;94(11):2674–2680. doi: 10.1161/01.cir.94.11.2674. [DOI] [PubMed] [Google Scholar]
  18. Bonow Robert O. Myocardial viability and prognosis in patients with ischemic left ventricular dysfunction. J Am Coll Cardiol. 2002 Apr 3;39(7):1159–1162. doi: 10.1016/s0735-1097(02)01732-1. [DOI] [PubMed] [Google Scholar]
  19. Braunwald E. Expanding indications for beta-blockers in heart failure. N Engl J Med. 2001 May 31;344(22):1711–1712. doi: 10.1056/NEJM200105313442210. [DOI] [PubMed] [Google Scholar]
  20. Cairns J. A., Connolly S. J., Roberts R., Gent M. Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. Lancet. 1997 Mar 8;349(9053):675–682. doi: 10.1016/s0140-6736(96)08171-8. [DOI] [PubMed] [Google Scholar]
  21. Canty J. M., Jr, Fallavollita J. A. Resting myocardial flow in hibernating myocardium: validating animal models of human pathophysiology. Am J Physiol. 1999 Jul;277(1 Pt 2):H417–H422. doi: 10.1152/ajpheart.1999.277.1.H417. [DOI] [PubMed] [Google Scholar]
  22. Challapalli S., Bonow R. O., Gheorghiade M. Medical management of heart failure secondary to coronary artery disease. Coron Artery Dis. 1998;9(10):659–674. [PubMed] [Google Scholar]
  23. Chaudhry F. A., Tauke J. T., Alessandrini R. S., Vardi G., Parker M. A., Bonow R. O. Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol. 1999 Sep;34(3):730–738. doi: 10.1016/s0735-1097(99)00252-1. [DOI] [PubMed] [Google Scholar]
  24. Cowie M. R., Wood D. A., Coats A. J., Thompson S. G., Poole-Wilson P. A., Suresh V., Sutton G. C. Incidence and aetiology of heart failure; a population-based study. Eur Heart J. 1999 Mar;20(6):421–428. doi: 10.1053/euhj.1998.1280. [DOI] [PubMed] [Google Scholar]
  25. Cuocolo A., Petretta M., Nicolai E., Pace L., Bonaduce D., Salvatore M., Trimarco B. Successful coronary revascularization improves prognosis in patients with previous myocardial infarction and evidence of viable myocardium at thallium-201 imaging. Eur J Nucl Med. 1998 Jan;25(1):60–68. doi: 10.1007/s002590050195. [DOI] [PubMed] [Google Scholar]
  26. Di Carli M. F., Asgarzadie F., Schelbert H. R., Brunken R. C., Laks H., Phelps M. E., Maddahi J. Quantitative relation between myocardial viability and improvement in heart failure symptoms after revascularization in patients with ischemic cardiomyopathy. Circulation. 1995 Dec 15;92(12):3436–3444. doi: 10.1161/01.cir.92.12.3436. [DOI] [PubMed] [Google Scholar]
  27. Di Carli M. F., Davidson M., Little R., Khanna S., Mody F. V., Brunken R. C., Czernin J., Rokhsar S., Stevenson L. W., Laks H. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1994 Mar 15;73(8):527–533. doi: 10.1016/0002-9149(94)90327-1. [DOI] [PubMed] [Google Scholar]
  28. Dilsizian V., Bonow R. O. Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation. 1993 Jan;87(1):1–20. doi: 10.1161/01.cir.87.1.1. [DOI] [PubMed] [Google Scholar]
  29. Eitzman D., al-Aouar Z., Kanter H. L., vom Dahl J., Kirsh M., Deeb G. M., Schwaiger M. Clinical outcome of patients with advanced coronary artery disease after viability studies with positron emission tomography. J Am Coll Cardiol. 1992 Sep;20(3):559–565. doi: 10.1016/0735-1097(92)90008-b. [DOI] [PubMed] [Google Scholar]
  30. Elefteriades J. A., Tolis G., Jr, Levi E., Mills L. K., Zaret B. L. Coronary artery bypass grafting in severe left ventricular dysfunction: excellent survival with improved ejection fraction and functional state. J Am Coll Cardiol. 1993 Nov 1;22(5):1411–1417. doi: 10.1016/0735-1097(93)90551-b. [DOI] [PubMed] [Google Scholar]
  31. Evans R. W., Manninen D. L., Garrison L. P., Jr, Maier A. M. Donor availability as the primary determinant of the future of heart transplantation. JAMA. 1986 Apr 11;255(14):1892–1898. [PubMed] [Google Scholar]
  32. Fallavollita J. A., Canty J. M., Jr Differential 18F-2-deoxyglucose uptake in viable dysfunctional myocardium with normal resting perfusion: evidence for chronic stunning in pigs. Circulation. 1999 Jun 1;99(21):2798–2805. doi: 10.1161/01.cir.99.21.2798. [DOI] [PubMed] [Google Scholar]
  33. Fallavollita J. A., Perry B. J., Canty J. M., Jr 18F-2-deoxyglucose deposition and regional flow in pigs with chronically dysfunctional myocardium. Evidence for transmural variations in chronic hibernating myocardium. Circulation. 1997 Apr 1;95(7):1900–1909. doi: 10.1161/01.cir.95.7.1900. [DOI] [PubMed] [Google Scholar]
  34. Firoozan S., Wei K., Linka A., Skyba D., Goodman N. C., Kaul S. A canine model of chronic ischemic cardiomyopathy: characterization of regional flow-function relations. Am J Physiol. 1999 Feb;276(2 Pt 2):H446–H455. doi: 10.1152/ajpheart.1999.276.2.H446. [DOI] [PubMed] [Google Scholar]
  35. Gheorghiade M., Bonow R. O. Chronic heart failure in the United States: a manifestation of coronary artery disease. Circulation. 1998 Jan 27;97(3):282–289. doi: 10.1161/01.cir.97.3.282. [DOI] [PubMed] [Google Scholar]
  36. Gioia G., Powers J., Heo J., Iskandrian A. S. Prognostic value of rest-redistribution tomographic thallium-201 imaging in ischemic cardiomyopathy. Am J Cardiol. 1995 Apr 15;75(12):759–762. doi: 10.1016/s0002-9149(99)80406-8. [DOI] [PubMed] [Google Scholar]
  37. Gropler R. J. Methodology governing the assessment of myocardial glucose metabolism by positron emission tomography and fluorine 18-labeled fluorodeoxyglucose. J Nucl Cardiol. 1994 Mar-Apr;1(2 Pt 2):S4–14. doi: 10.1007/BF02940063. [DOI] [PubMed] [Google Scholar]
  38. Gunning M. G., Anagnostopoulos C., Knight C. J., Pepper J., Burman E. D., Davies G., Fox K. M., Pennell D. J., Ell P. J., Underwood S. R. Comparison of 201Tl, 99mTc-tetrofosmin, and dobutamine magnetic resonance imaging for identifying hibernating myocardium. Circulation. 1998 Nov 3;98(18):1869–1874. doi: 10.1161/01.cir.98.18.1869. [DOI] [PubMed] [Google Scholar]
  39. Gunning M. G., Chua T. P., Harrington D., Knight C. J., Burman E., Pennell D. J., Pepper J., Fox K., Underwood S. R. Hibernating myocardium: clinical and functional response to revascularisation. Eur J Cardiothorac Surg. 1997 Jun;11(6):1105–1112. doi: 10.1016/s1010-7940(97)01211-6. [DOI] [PubMed] [Google Scholar]
  40. Gunning Mark G., Kaprielian Raffi R., Pepper John, Pennell Dudley J., Sheppard Mary N., Severs Nicholas J., Fox Kim M., Underwood S. Richard. The histology of viable and hibernating myocardium in relation to imaging characteristics. J Am Coll Cardiol. 2002 Feb 6;39(3):428–435. doi: 10.1016/s0735-1097(01)01766-1. [DOI] [PubMed] [Google Scholar]
  41. Kaul S. There may be more to myocardial viability than meets the eye. Circulation. 1995 Nov 15;92(10):2790–2793. doi: 10.1161/01.cir.92.10.2790. [DOI] [PubMed] [Google Scholar]
  42. Kim R. J., Wu E., Rafael A., Chen E. L., Parker M. A., Simonetti O., Klocke F. J., Bonow R. O., Judd R. M. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000 Nov 16;343(20):1445–1453. doi: 10.1056/NEJM200011163432003. [DOI] [PubMed] [Google Scholar]
  43. Lee K. S., Marwick T. H., Cook S. A., Go R. T., Fix J. S., James K. B., Sapp S. K., MacIntyre W. J., Thomas J. D. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction. Relative efficacy of medical therapy and revascularization. Circulation. 1994 Dec;90(6):2687–2694. doi: 10.1161/01.cir.90.6.2687. [DOI] [PubMed] [Google Scholar]
  44. Leoncini M., Marcucci G., Sciagrà R., Frascarelli F., Traini A. M., Mondanelli D., Magni M., Bini L., Bellandi F., Mennuti A. Nitrate-enhanced gated technetium 99m sestamibi SPECT for evaluating regional wall motion at baseline and during low-dose dobutamine infusion in patients with chronic coronary artery disease and left ventricular dysfunction: comparison with two-dimensional echocardiography. J Nucl Cardiol. 2000 Sep-Oct;7(5):426–431. doi: 10.1067/mnc.2000.108029. [DOI] [PubMed] [Google Scholar]
  45. Levine M. G., McGill C. C., Ahlberg A. W., White M. P., Giri S., Shareef B., Waters D., Heller G. V. Functional assessment with electrocardiographic gated single-photon emission computed tomography improves the ability of technetium-99m sestamibi myocardial perfusion imaging to predict myocardial viability in patients undergoing revascularization. Am J Cardiol. 1999 Jan 1;83(1):1–5. doi: 10.1016/s0002-9149(98)00772-3. [DOI] [PubMed] [Google Scholar]
  46. Maes A., Flameng W., Nuyts J., Borgers M., Shivalkar B., Ausma J., Bormans G., Schiepers C., De Roo M., Mortelmans L. Histological alterations in chronically hypoperfused myocardium. Correlation with PET findings. Circulation. 1994 Aug;90(2):735–745. doi: 10.1161/01.cir.90.2.735. [DOI] [PubMed] [Google Scholar]
  47. Marwick T. H., Nemec J. J., Lafont A., Salcedo E. E., MacIntyre W. J. Prediction by postexercise fluoro-18 deoxyglucose positron emission tomography of improvement in exercise capacity after revascularization. Am J Cardiol. 1992 Apr 1;69(9):854–859. doi: 10.1016/0002-9149(92)90782-t. [DOI] [PubMed] [Google Scholar]
  48. Meluzín J., Cerný J., Frélich M., Stetka F., Spinarová L., Popelová J., Stípal R. Prognostic value of the amount of dysfunctional but viable myocardium in revascularized patients with coronary artery disease and left ventricular dysfunction. Investigators of this Multicenter Study. J Am Coll Cardiol. 1998 Oct;32(4):912–920. doi: 10.1016/s0735-1097(98)00324-6. [DOI] [PubMed] [Google Scholar]
  49. Mule Jacopo Dalle, Bax Jeroen J., Zingone Bartolo, Martinelli Felice, Burelli Claudio, Stefania Anna, DiSipio Liberata, Soravia Giorgio. The beneficial effect of revascularization on jeopardized myocardium: reverse remodeling and improved long-term prognosis. Eur J Cardiothorac Surg. 2002 Sep;22(3):426–430. doi: 10.1016/s1010-7940(02)00359-7. [DOI] [PubMed] [Google Scholar]
  50. Pagano D., Bonser R. S., Townend J. N., Ordoubadi F., Lorenzoni R., Camici P. G. Predictive value of dobutamine echocardiography and positron emission tomography in identifying hibernating myocardium in patients with postischaemic heart failure. Heart. 1998 Mar;79(3):281–288. doi: 10.1136/hrt.79.3.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  51. Pagano D., Lewis M. E., Townend J. N., Davies P., Camici P. G., Bonser R. S. Coronary revascularisation for postischaemic heart failure: how myocardial viability affects survival. Heart. 1999 Dec;82(6):684–688. doi: 10.1136/hrt.82.6.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
  52. Pagley P. R., Beller G. A., Watson D. D., Gimple L. W., Ragosta M. Improved outcome after coronary bypass surgery in patients with ischemic cardiomyopathy and residual myocardial viability. Circulation. 1997 Aug 5;96(3):793–800. doi: 10.1161/01.cir.96.3.793. [DOI] [PubMed] [Google Scholar]
  53. Perrone-Filardi P., Pace L., Prastaro M., Squame F., Betocchi S., Soricelli A., Piscione F., Indolfi C., Crisci T., Salvatore M. Assessment of myocardial viability in patients with chronic coronary artery disease. Rest-4-hour-24-hour 201Tl tomography versus dobutamine echocardiography. Circulation. 1996 Dec 1;94(11):2712–2719. doi: 10.1161/01.cir.94.11.2712. [DOI] [PubMed] [Google Scholar]
  54. Pigott J. D., Kouchoukos N. T., Oberman A., Cutter G. R. Late results of surgical and medical therapy for patients with coronary artery disease and depressed left ventricular function. J Am Coll Cardiol. 1985 May;5(5):1036–1045. doi: 10.1016/s0735-1097(85)80003-6. [DOI] [PubMed] [Google Scholar]
  55. Rahimtoola S. H. The hibernating myocardium. Am Heart J. 1989 Jan;117(1):211–221. doi: 10.1016/0002-8703(89)90685-6. [DOI] [PubMed] [Google Scholar]
  56. Samady H., Elefteriades J. A., Abbott B. G., Mattera J. A., McPherson C. A., Wackers F. J. Failure to improve left ventricular function after coronary revascularization for ischemic cardiomyopathy is not associated with worse outcome. Circulation. 1999 Sep 21;100(12):1298–1304. doi: 10.1161/01.cir.100.12.1298. [DOI] [PubMed] [Google Scholar]
  57. Sandler M. P., Patton J. A. Fluorine 18-labeled fluorodeoxyglucose myocardial single-photon emission computed tomography: an alternative for determining myocardial viability. J Nucl Cardiol. 1996 Jul-Aug;3(4):342–349. doi: 10.1016/s1071-3581(96)90095-1. [DOI] [PubMed] [Google Scholar]
  58. Schinkel A. F. L., Bax J. J., Sozzi F. B., Boersma E., Valkema R., Elhendy A., Roelandt J. R. T. C., Poldermans D. Prevalence of myocardial viability assessed by single photon emission computed tomography in patients with chronic ischaemic left ventricular dysfunction. Heart. 2002 Aug;88(2):125–130. doi: 10.1136/heart.88.2.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  59. Schneider C. A., Voth E., Gawlich S., Baer F. M., Horst M., Schicha H., Erdmann E., Sechtem U. Significance of rest technetium-99m sestamibi imaging for the prediction of improvement of left ventricular dysfunction after Q wave myocardial infarction: importance of infarct location adjusted thresholds. J Am Coll Cardiol. 1998 Sep;32(3):648–654. doi: 10.1016/s0735-1097(98)00291-5. [DOI] [PubMed] [Google Scholar]
  60. Sciagrà R., Pellegri M., Pupi A., Bolognese L., Bisi G., Carnovale V., Santoro G. M. Prognostic implications of Tc-99m sestamibi viability imaging and subsequent therapeutic strategy in patients with chronic coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol. 2000 Sep;36(3):739–745. doi: 10.1016/s0735-1097(00)00797-x. [DOI] [PubMed] [Google Scholar]
  61. Senior R., Kaul S., Lahiri A. Myocardial viability on echocardiography predicts long-term survival after revascularization in patients with ischemic congestive heart failure. J Am Coll Cardiol. 1999 Jun;33(7):1848–1854. doi: 10.1016/s0735-1097(99)00102-3. [DOI] [PubMed] [Google Scholar]
  62. Sloof G. W., Knapp F. F., Jr, van Lingen A., Eersels J., Poldermans D., Bax J. J. Nuclear imaging is more sensitive for the detection of viable myocardium than dobutamine echocardiography. Nucl Med Commun. 2003 Apr;24(4):375–381. doi: 10.1097/00006231-200304000-00006. [DOI] [PubMed] [Google Scholar]
  63. Sun K. T., Czernin J., Krivokapich J., Lau Y. K., Böttcher M., Maurer G., Phelps M. E., Schelbert H. R. Effects of dobutamine stimulation on myocardial blood flow, glucose metabolism, and wall motion in normal and dysfunctional myocardium. Circulation. 1996 Dec 15;94(12):3146–3154. doi: 10.1161/01.cir.94.12.3146. [DOI] [PubMed] [Google Scholar]
  64. Tamaki N., Kawamoto M., Takahashi N., Yonekura Y., Magata Y., Nohara R., Kambara H., Sasayama S., Hirata K., Ban T. Prognostic value of an increase in fluorine-18 deoxyglucose uptake in patients with myocardial infarction: comparison with stress thallium imaging. J Am Coll Cardiol. 1993 Nov 15;22(6):1621–1627. doi: 10.1016/0735-1097(93)90586-p. [DOI] [PubMed] [Google Scholar]
  65. Tawakol A., Gewirtz H. Does CABG improve left ventricular ejection fraction in patients with ischemic cardiomyopathy, and does it matter? J Nucl Med. 2001 Jan;42(1):87–90. [PubMed] [Google Scholar]
  66. Tawakol A., Skopicki H. A., Abraham S. A., Alpert N. M., Fischman A. J., Picard M. H., Gewirtz H. Evidence of reduced resting blood flow in viable myocardial regions with chronic asynergy. J Am Coll Cardiol. 2000 Dec;36(7):2146–2153. doi: 10.1016/s0735-1097(00)00999-2. [DOI] [PubMed] [Google Scholar]
  67. Vanoverschelde J. L., Melin J. A. The pathophysiology of myocardial hibernation: current controversies and future directions. Prog Cardiovasc Dis. 2001 Mar-Apr;43(5):387–398. doi: 10.1053/pcad.2001.20655. [DOI] [PubMed] [Google Scholar]
  68. Vanoverschelde J. L., Wijns W., Depré C., Essamri B., Heyndrickx G. R., Borgers M., Bol A., Melin J. A. Mechanisms of chronic regional postischemic dysfunction in humans. New insights from the study of noninfarcted collateral-dependent myocardium. Circulation. 1993 May;87(5):1513–1523. doi: 10.1161/01.cir.87.5.1513. [DOI] [PubMed] [Google Scholar]
  69. Westaby Stephen, Frazier O. H., Pigott David W., Saito Satoshi, Jarvik Robert K. Implant technique for the Jarvik 2000 Heart. Ann Thorac Surg. 2002 Apr;73(4):1337–1340. doi: 10.1016/s0003-4975(01)03599-8. [DOI] [PubMed] [Google Scholar]
  70. White H. D., Norris R. M., Brown M. A., Brandt P. W., Whitlock R. M., Wild C. J. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation. 1987 Jul;76(1):44–51. doi: 10.1161/01.cir.76.1.44. [DOI] [PubMed] [Google Scholar]
  71. Williams M. J., Odabashian J., Lauer M. S., Thomas J. D., Marwick T. H. Prognostic value of dobutamine echocardiography in patients with left ventricular dysfunction. J Am Coll Cardiol. 1996 Jan;27(1):132–139. doi: 10.1016/0735-1097(95)00393-2. [DOI] [PubMed] [Google Scholar]
  72. Xu Chunhui, Police Shailaja, Rao Namitha, Carpenter Melissa K. Characterization and enrichment of cardiomyocytes derived from human embryonic stem cells. Circ Res. 2002 Sep 20;91(6):501–508. doi: 10.1161/01.res.0000035254.80718.91. [DOI] [PubMed] [Google Scholar]
  73. Yoshida K., Gould K. L. Quantitative relation of myocardial infarct size and myocardial viability by positron emission tomography to left ventricular ejection fraction and 3-year mortality with and without revascularization. J Am Coll Cardiol. 1993 Oct;22(4):984–997. doi: 10.1016/0735-1097(93)90407-r. [DOI] [PubMed] [Google Scholar]
  74. Zafrir N., Leppo J. A., Reinhardt C. P., Dahlberg S. T. Thallium reinjection versus standard stress/delay redistribution imaging for prediction of cardiac events. J Am Coll Cardiol. 1998 May;31(6):1280–1285. doi: 10.1016/s0735-1097(98)00079-5. [DOI] [PubMed] [Google Scholar]
  75. Zamorano José, Delgado Juan, Almería Carlos, Moreno R., Gómez Sánchez Miguel, Rodrigo José, Fernández Cristina, Ferreiros Joaquin, Rufilanchas Juan, Sánchez-Harguindey Luis. Reason for discrepancies in identifying myocardial viability by thallium-201 redistribution, magnetic resonance imaging, and dobutamine echocardiography. Am J Cardiol. 2002 Sep 1;90(5):455–459. doi: 10.1016/s0002-9149(02)02513-4. [DOI] [PubMed] [Google Scholar]
  76. al-Mohammad A., Mahy I. R., Norton M. Y., Hillis G., Patel J. C., Mikecz P., Walton S. Prevalence of hibernating myocardium in patients with severely impaired ischaemic left ventricles. Heart. 1998 Dec;80(6):559–564. doi: 10.1136/hrt.80.6.559. [DOI] [PMC free article] [PubMed] [Google Scholar]
  77. van der Wall E. E., Bax J. Current clinical relevance of cardiovascular magnetic resonance and its relationship to nuclear cardiology. J Nucl Cardiol. 1999 Jul-Aug;6(4):462–469. doi: 10.1016/s1071-3581(99)90013-2. [DOI] [PubMed] [Google Scholar]
  78. vom Dahl J., Altehoefer C., Sheehan F. H., Buechin P., Schulz G., Schwarz E. R., Koch K. C., Uebis R., Messmer B. J., Buell U. Effect of myocardial viability assessed by technetium-99m-sestamibi SPECT and fluorine-18-FDG PET on clinical outcome in coronary artery disease. J Nucl Med. 1997 May;38(5):742–748. [PubMed] [Google Scholar]

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