Congestive heart failure myocardial viability study

Resident Survival Guide

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Chronic Pharmacotherapy in HFrEF Diuretics ACE Inhibitors Angiotensin receptor blockers Aldosterone Antagonists Beta Blockers Ca Channel Blockers Nitrates Hydralazine Positive Inotropics Anticoagulants Angiotensin Receptor-Neprilysin Inhibitor Antiarrhythmic Drugs Nutritional Supplements Hormonal Therapies Drugs to Avoid Drug Interactions Treatment of underlying causes Associated conditions
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Surgical Therapy: Biventricular Pacing or Cardiac Resynchronization Therapy (CRT) Implantation of Intracardiac Defibrillator Ultrafiltration Cardiac Surgery Left Ventricular Assist Devices (LVADs) Cardiac Transplantation
ACC/AHA Guideline Recommendations Initial and Serial Evaluation of the HF Patient Hospitalized Patient Patients With a Prior MI Sudden Cardiac Death Prevention Surgical/Percutaneous/Transcather Interventional Treatments of HF Patients at high risk for developing heart failure (Stage A) Patients with cardiac structural abnormalities or remodeling who have not developed heart failure symptoms (Stage B) Patients with current or prior symptoms of heart failure (Stage C) Patients with refractory end-stage heart failure (Stage D) Coordinating Care for Patients With Chronic HF Quality Metrics/Performance Measures
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Congestive heart failure end-of-life considerations
Specific Groups: Special Populations Patients who have concomitant disorders Obstructive Sleep Apnea in the Patient with CHF NSTEMI with Heart Failure and Cardiogenic Shock
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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

Single-photon emission CT (SPECT) can also be used to assess myocardial ischemia and viability, myocardial inflammation or infiltration. Scintigraphy with technetium (Tc)-labeled bisphosphonate has shown high sensitivity and specificity for imaging cardiac transthyretin amyloid.

Myocardial Viability Studies

Common imaging modalities to assess myocardial viability include:

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

Class IIb

"Non-invasive stress imaging (CMR, stress echocardiography, SPECT, PET) may be considered for the assessment of myocardial ischemia and viability in patients with CAD who are considered suitable for coronary revascularization. (Level of Evidence: B) "

". Exercise testing may be considered to detect reversible myocardial ischemia and investigate the cause of dyspnea(Level of Evidence: C) "

The above table adopted from 2021 ESC Guideline

Related Chapters

• Stress Radionuclide Myocardial Perfusion Imaging

• Comparison of exercise SPECT imaging and Exercise Echocardiography

• Techniques used to Assess Myocardial Viability