Congestive heart failure myocardial viability study

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

• Myocardial viability studies can determine whether hypocontractile myocardium is viable but just hibernating, and could therefore benefit from revascularization.

• Common imaging modalities to assess myocardial viability include:

• Dobutamine echocardiography
• Nuclear tests (SPECT or PET)
• Cardiac MRI

ACC/AHA Guidelines- Myocardial Viability Studies Recommendation

Class IIa

"1. Noninvasive imaging to detect myocardial ischemia and viability is reasonable in patients presenting with heart failure who have known coronary artery disease and no angina unless the patient is not eligible for revascularization of any kind. (Level of Evidence: B) "

Class IIb

"1. Noninvasive imaging may be considered to define the likelihood of coronary artery disease in patients with heart failure and left ventricular dysfunction. (Level of Evidence: C) "

Related Chapters

• Stress Radionuclide Myocardial Perfusion Imaging

• Comparison of exercise SPECT imaging and Exercise Echocardiography

• Techniques used to Assess Myocardial Viability

Vote on and Suggest Revisions to the Current Guidelines

• The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines

Guidelines Resources

• The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult

• 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation

References

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