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Review
. 2004 Aug;90 Suppl 5(Suppl 5):v26-33.
doi: 10.1136/hrt.2002.007575.

Radionuclide techniques for the assessment of myocardial viability and hibernation

J J Bax  1 , E E van der Wall, M Harbinson
Affiliations
Review

Radionuclide techniques for the assessment of myocardial viability and hibernation

J J Bax et al. Heart. 2004 Aug.
No abstract available

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Figures

Figure 1
Figure 1
Changes in left ventricular ejection fraction (LVEF), observed in 47 patients with ischaemic cardiomyopathy undergoing revascularisation. Improvement in LVEF was defined as an increase in LVEF of ⩾ 5% after revascularisation. (Data based on Bax and colleagues.13)
Figure 2
Figure 2
Bar graph illustrating the influence of FDG PET imaging on subsequent patient management. The grey bars indicate the number of patients and their planned treatment before FDG PET was performed; the white bars demonstrate the number of patients in whom treatment was changed according to the FDG PET results. HTX, heart transplantation; Med, medical treatment; Rev, revascularisation. (Reprinted from Bax and colleagues,44 with permission).
Figure 3
Figure 3
Bar graphs indicating the discrepancy between contractile reserve (assessed by DSE) and different nuclear imaging techniques. CR+, contractile reserve present; CR–, contractile reserve absent; DSE, dobutamine stress echocardiography; FDG, F18-fluorodeoxyglucose; FFA, free fatty acids. (Based on Sloof and colleagues.33)
Figure 4
Figure 4
Sensitivity and specificity of the various viability techniques to predict improvement of regional left ventricular function after revascularisation. DSE, dobutamine stress echocardiography; FDG, F18-fluorodeoxyglucose; MIBI, sestamibi; Tl-201 RI, thallium-201 reinjection; Tl-201 RR, thallium-201 rest-redistribution. (Data based on Bax and colleagues.26)
Figure 5
Figure 5
Sensitivity and specificity of dobutamine stress echocardiography (DSE) and nuclear imaging (Nuclear) techniques (based on pooled data from 11 studies (n = 325 patients) that performed a direct comparison between DSE and nuclear imaging to predict improvement in regional LV function after revascularisation). The sensitivity of the nuclear techniques was significantly higher as compared to DSE, whereas the specificity of DSE was significantly higher. (Data based on Bax and colleagues.26)
Figure 6
Figure 6
Prognostic value of the viability studies: event rate is plotted versus presence/absence of viability and treatment (medical/revascularisation). The highest mortality is observed in the patients with viable myocardium who were treated medically. Med: medical treatment; Revasc: revascularisation. (Based on pooled data from references 47, 48, 61–75.)
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