NYMC Faculty Publications
Myocardial Viability Assessment Before Surgical Revascularization in Ischemic Cardiomyopathy: JACC Review Topic of the Week
Author Type(s)
Faculty
DOI
10.1016/j.jacc.2021.07.004
Journal Title
Journal of the American College of Cardiology
First Page
1068
Last Page
1077
Document Type
Review Article
Publication Date
9-7-2021
Department
Medicine
Abstract
Ischemic cardiomyopathy results from the combination of scar with fibrosis replacement and areas of dysfunctional but viable myocardium that may improve contractile function with revascularization. Observational studies reported that only patients with substantial amounts of myocardial viability had better outcomes following surgical revascularization. Accordingly, dedicated noninvasive techniques have evolved to quantify viable myocardium with the objective of selecting patients for this form of therapeutic intervention. However, prospective trials have not confirmed the interaction between myocardial viability and the treatment effect of revascularization. Furthermore, recent observations indicate that recovery of left ventricular function is not the principal mechanism by which surgical revascularization improves prognosis. In this paper, the authors describe a more contemporary application of viability testing that is founded on the alternative concept that the main goal of surgical revascularization is to prevent further damage by protecting the residual viable myocardium from subsequent acute coronary events.
Recommended Citation
Panza, J. A., Chrzanowski, L., & Bonow, R. O. (2021). Myocardial Viability Assessment Before Surgical Revascularization in Ischemic Cardiomyopathy: JACC Review Topic of the Week. Journal of the American College of Cardiology, 78 (10), 1068-1077. https://doi.org/10.1016/j.jacc.2021.07.004