Post-Infarction Myocardial Viability and Angina at Everyday Life Activities versus Treadmill Exercise Test

Background: Myocardial viability (VIA) prevalence in post myocardial infarction (MI) patients (pts) in association with angina (ANG) or not has not been prospectively evaluated. Methods and Findings:Fifty-five post-MI pts with reduced ejection fraction (EF≤40%) underwent stress thallium-201 scintigraphy (Tl-201) viability (VIA) evaluation.ANG at exercise-treadmill-test (ETT) (Borg scale) and at everyday-life (Canadian Cardiovascular Society -CCS) classification was recorded.Groups VIA (29 pts -53%) vs non-VIA respectively had similar EF (31 ± 7)% vs (33 ± 8)% (NS), higher diseased vessels number 2.8 ± 1.6 vs 1.9 ± 1.3 (p=0.02),CCS 1.7 ± 0.8 vs 1.3 ± 0.6 (p<0.05),CCS≥2 71% vs 41% (p<0.03).Five pts from each group reported ETT ANG (17% vs 21% -NS), with Borg scale 7.7 ± 3.0 vs 7.2 ± 2.4 (NS).CCS≥2 was associated with greater 201 Tl reversibility indices within stress defect (p<0.04) or total myocardial mass reversibility (p<0.02).Binary logistics analysis associated VIA positively with number of diseased vessels and negatively with smoking, while CCS≥2 ANG positively with number of diseased vessels.The main limitation is the relatively small number of pts.Conclusions: Viability, while not significantly correlated to ETT angina, was positively associated only with more frequent everyday-life (CCS) angina.Clinically, in ischemic cardiomyopathy VIA evaluation is indicated, regardless of ANG.