Why the study?
Contrast MRI accurately determines myocardial necrosis area but remains inaccessible in most hospitals, making estimation by ubiquitous non-invasive methods like ECG and echocardiography relevant.
This review highlights the role of contrast-enhanced MRI as the gold standard for assessing myocardial necrosis and viability, while emphasizing the growing utility of advanced echocardiography techniques like speckle tracking.
May inform viability assessment when MRI unavailable; leaves open validation of echo and ECG alternatives in prospective trials.
An accurate quantitative assessment of myocardium necrosis area and the viable zone (stunned and hibernating) in patients with myocardial infarction is crucial for the preoperative patient selection and predicting the cardiac surgery effectiveness. Currently, researchers and clinicians are most interested in the problem of determining the viable myocardium zone. However, only the necrosis zone area directly correlates with the patients prognosis and determines the heart pathological remodeling processes. In the distant period, the data obtained can be used to predict the post-infarction period course or for analysis the relationship of the necrosis zone with arrhythmogenesis, and a number of other indicators. Thus, the necrosis zone and the viable myocardium zone are two parameters that need to be monitored in dynamics in all patients after myocardial infarction. The most accurate and reproducible method for determining the necrosis area is contrast magnetic resonance imaging of the heart, however, this technique is still inaccessible in most hospitals. In this regard, it remains relevant to estimate the necrotic myocardium area by ubiquitous non-invasive methods such as electrocardiography and echocardiography.
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Шиготарова et al. (2020) studied this question.
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