Practical Implications of Myocardial Viability Studies

Figure 1. Main feature of the physiopathology of stunned myocardium and hibernating myocardium [adapted from Chareonthaitawee et al.8]

Figure 2. Images of rest (upper line) and nitrate-enhanced rest (lower line) myocardial perfusion scintigraphy, showing improvement of perfusion in anterior (apical, medial and basal) and anterolateral (medial and basal) segments.

Figure 3. Myocardial perfusion scintigraphy with 201Tálio for assessment of myocardial viability; stress imaging (upper line) and 24-hour redistribution imaging after injection of the radiotracer 201Tálio (lower line), showing improvement of perfusion in anterior (apical, medial and basal) and anterolateral (medial and basal) segments.

Figure 4. Myocardial perfusion scintigraphy with 99mTc-Sestamibi (upper line) and 18F-FDG PET (lower line) for assessment of myocardial viability, showing improvement in perfusion/metabolism in anterior (apical, medial and basal), apical septal, anteroseptal (medial and basal) and inferoseptal (medial and basal) segments; “mismatch” pattern.

Figure 5. Patterns of transmurality of infarction in the presence and absence of viability by cardiac magnetic resonance