In patients with ischaemic heart failure without angina, 55% had substantial myocardial viability, defined as 5 or more dysfunctional segments with 50% or less transmural scar thickness.
Cross-Sectional (n=193)
Single-blind
No
In patients with ischemic heart failure without angina, over half have substantial viable but dysfunctional myocardium on CMR, suggesting potential for functional recovery with appropriate intervention.
BACKGROUND: Cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) can provide unique data on the transmural extent of scar/viability. We assessed the prevalence of dysfunctional myocardium, including partial thickness scar, which could contribute to left ventricular contractile dysfunction in patients with heart failure and ischaemic heart disease who denied angina symptoms. METHODS: We invited patients with ischaemic heart disease and a left ventricular ejection fraction 50% of wall thickness. Of 1522 segments with normal contractile function, only 98 (6%) had evidence of scar on CMR. Overall, 182 (94%) patients had ≥1 and 107 (55%) patients had ≥5 segments with contractile dysfunction that had no scar or ≤50% transmural scar suggesting viability. CONCLUSIONS: In this cohort of patients with left ventricular systolic dysfunction and ischaemic heart disease, about half of all segments had contractile dysfunction but only one third of these had > 50% of the wall thickness affected by scar, suggesting that most dysfunctional segments could improve in response to an appropriate intervention.
Bourantas et al. (2011) conducted a cross-sectional in Heart failure of ischaemic origin (n=193). Cardiovascular magnetic resonance with late gadolinium enhancement was evaluated on Prevalence of substantial myocardial viability (≥5 dysfunctional segments with ≤50% scar thickness). In patients with ischaemic heart failure without angina, 55% had substantial myocardial viability, defined as 5 or more dysfunctional segments with 50% or less transmural scar thickness.