Abstract
The concept of “hibernating myocardium”, 1 defined as impaired regional myocardial contractility with preserved viability, bears important clinical implications. Revascularization of patients with hibernating myocardium brings about a clear and convincing reduction of mortality and morbidity. Revascularization of necrotic / infarcted tissue does not show any effect.2 Therefore, it is foreseeable that accurate diagnostic methods to differentiate hibernating from necrotic myocardium will help in reaching a decision to revascularize. Although the magnitude of the problem of differentiating viable from necrotic tissue in areas of diminished contractility, is estimated to be only 10% of all patients eligible for revascularization,3 the high cost of revascularization and ensuing cardiac morbidity and the major impact on quality of life justify the cost and effort of a diagnostic intervention to avert these problems by far.
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References
Rahimtoola SH. The hibernating myocardium. Am Heart J 1989; 117:211–21.
Yusuf S, Zucker D, Peduzzi P et al. Effect of coronary artery bypass graft surgery on survival: overview of 10-years results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialist Collaboration. Lancet 1994;344:563–70.
Unpublished experience of the Thoraxcenter of the University Hospital Groningen during 1993 and 1994. A centre with an estimated annual coronary angiogram review rate of 5000 resulting in a patient turnover of approximately 1200 CABG and 1200 PTCA per year.
Braunwald E, Kloner RA. The stunned myocardium: Prolonged, postischemic ventricular dysfunction. Circulation 1982;66:1146–9.
Zaret BL, Wackers FJ. Nuclear cardiology. Second of two parts. N Engl J Med 1993:329:855–63.
Matzusaki M, Gallagher KP, Kemper WS et al. Sustained regional dysfunction produced by prolonged coronary stenosis: Gradual recovery after reperfusion. Circulation 1987;68:170–82.
Fedele FA, Gerwitz H, Capone RJ et al. Metabolic response to prolonged reduction of myocardial blood flow distal to a severe coronary stenosis. Circulation 1988;78:729–35.
Opie LH. Effects of regional ischemia on metabolism of glucose and fatty acids. Circ Res 1976;38:152–74.
Vanoverschelde JL, Wijns W, Depre C et al. Mechanisms of chronic regional postischemic dysfunction in humans. New insights from the study of non infarcted collateral dependent myocardium. Circulation 1993;87:1513–23.
Borgers M, Ausma J, Wijffels M et al. Atrial fibrillation in the goat: a model for chronic hibernating myocardium. Circulation 1994;90:1–467 (Abstract).
Eisner D, Riegger GAJ. Animal models of heart failure. Curr Opin Cardiol 1991;6:334–40.
Blanksma PK, Willemsen ATM, Meeder JG et al. Quantitative myocardial mapping of perfusion and metabolism using parametric polar map display in cardiac PET. J Nucl Med 1995;36:153–58.
Yamamoto Y, De Silva R, Rhodes CG et al. A new strategy for the assessment of viable and regional myocardial blood flow using 15-O-water and dynamic positron emission tomography. Circulation 1992;86:167–78.
Phelps ME, Hoffman EJ, Selin CE et al. Investigation of 18F-2-fluoro-2-deoxyglucose for the measure of myocardial glucose metabolism. J Nucl Med 1978; 19:1311–9.
Knuuti MJ, Yki-Järvinen H, Voipio-Pulkki LM et al. Enhancement of myocardial (fluorine-18)fluorodeoxyglucose uptake by a nicotinic acid derivative. J Nucl Med 1994;35:989–98.
Knuuti MJ, Nuutila P, Ruotsalainen U et al. The value of quantitative analysis of glucose utilization in detection of myocardial viability by PET. J Nucl Med 1993;34:2068–75.
Eitzman D, Al-Aouar Z, Kanter HL et al. Clinical outcome of patients with advanced coronary artery disease after viability studies with positron emission tomography. J Am Coll Cardiol 1992;20:559–65.
Brown M, Marshall DR, Sobel BE et al. Delineation of myocardial oxygen utilization with carbon-11 labeled acetate. Circulation 1987;76:687–96.
Brown M, Myers DW, Bergmann SR et al. Noninvasive assessment of canine myocardial oxidative metabolism with carbon-11 acetate and positron emission tomography. J Am Coll Cardiol 1988; 12:1054–63.
Gropler RJ, Geltman EM, Sampathkumaran K et al. Comparison of carbon-11-acetate with fluorine-18-fluorodeoxyglucose for delineating viable myocardium by positron emission tomography. J Am Coll Cardiol 1993;22:1587–97.
Tillisch J, Brunken R, Marshall R et al. Reversibility of cardiac wall-motion abnormalities predicted by positron emission tomography. N Engl J Med 1986;314:884–8.
Tamaki N, Yonekura Y, Yamashita K et al. Positron emission tomography using fluorine-18-deoxyglucose in evaluation of coronary artery bypass grafting. Am J Cardiol 1989;64:860–5.
Marwick HT, Maclntyre WJ, Lafont A et al. Metabolic responses of hibernating and infarcted myocardium to revascularization. A follow up study of regional perfusion, function and metabolism. Circulation 1992;85:1347–53.
Lucignani G, Paolini G, Landoni C et al. Presurgical identification of hibernating myocardium by combined use of technetium-99m hexakis 2-methoxyisobutylisonitrile single photon emission tomography and fluorine-18 fluoro-2-deoxy-d-glucose positron emission tomography in patients with coronary artery disease. Eur J Nucl Med 1992;19:874–81.
Pierard LA, De Landsheere CM, Berthe C et al. Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: comparison with positron emission tomography. J Am Coll Cardiol 1990;15:1021–31.
Schwaiger M, Brunken R, Grover-McKay M et al. Regional myocardial metabolism in patients with acute myocardial infarction assessed by positron emission tomography. J Am Coll Cardiol 1986;8:800–8.
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Tan, ES. (1995). Positron Emission Tomography Assessment of Myocardial Viability. In: van der Wall, E.E., Blanksma, P.K., Niemeyer, M.G., Paans, A.M.J. (eds) Cardiac Positron Emission Tomography. Developments in Cardiovascular Medicine, vol 166. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-0023-6_3
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DOI: https://doi.org/10.1007/978-94-011-0023-6_3
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