End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation

Cwajg, Jucyléa; Cwajg, Eduardo; Nagueh, Sherif F.; He, Zhaoyi; Qureshi, Usman; Olmos, Leopoldo; Quiñones, Miguel Á.; Verani, Mario S.; Winters, William L.; Zoghbi, William A.

doi:10.1016/s0735-1097(00)00525-8

Cited by 170 publications

(27 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diastolic wall thickness is >6 mm by CMR 70 or 7 mm on trans-thoracic echocardiography, 65 though recent studies have demonstrated that thinning below these thresholds, in the absence of extensive scar, does not preclude recovery. 71 With inotropic stimulation, hibernating myocardium shows ‘contractile reserve’ or a ‘biphasic response’, with an improvement in contractile function on low-dose/effort stress prior to deteriorating at higher workloads.…”

Section: Taxonomy For Myocardial Segmentsmentioning

confidence: 97%

“…63,64 The time course of recovery of LV systolic function following revascularization is dependent upon the severity of myocardial change, with some studies suggesting that irreversible remodelling may occur with extended hibernation despite successful revascularization. 64,65 However, it is not known if delayed recovery may occur beyond study duration. 66 …”

Section: Taxonomy For Myocardial Segmentsmentioning

confidence: 99%

See 1 more Smart Citation

Taxonomy of segmental myocardial systolic dysfunction

et al. 2016

View full text Add to dashboard Cite

The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms ‘viable’ and ‘hibernating’ are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions. The results of several large trials have led to renewed discussion about the classification of dysfunctional myocardial segments. This article aims to describe the diverse myocardial pathologies that may affect the myocardium in ischaemic heart disease and cardiomyopathy, and how they may be assessed with non-invasive imaging techniques in order to provide a taxonomy of myocardial dysfunction.

show abstract

Section: Taxonomy For Myocardial Segmentsmentioning

confidence: 97%

Section: Taxonomy For Myocardial Segmentsmentioning

confidence: 99%

Taxonomy of segmental myocardial systolic dysfunction

et al. 2016

View full text Add to dashboard Cite

show abstract

“…This approach uses a cut-off value of ≥ 5.5–6 mm in most studies to determine whether a segment is viable [14]. Echocardiography and CMR can be used to measure the EDWT with the advantage of CMR that provides accurate measurements of the entire LV wall.…”

Section: Imaging Techniques Employed For Viability Assessmentmentioning

confidence: 99%

Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion

Elfigih

Henein

2014

IJC Heart & Vasculature

View full text Add to dashboard Cite

Coronary artery disease (CAD) is the most prevalent and single most common cause of morbidity and mortality [1] with the resulting left ventricular (LV) dysfunction an important complication. The distinction between viable and non-viable myocardium in patients with LV dysfunction is a clinically important issue among possible candidates for myocardial revascularization. Several available non-invasive techniques are used to detect and assess ischemia and myocardial viability. These techniques include echocardiography, radionuclide images, cardiac magnetic resonance imaging and recently myocardial computed tomography perfusion imaging. This review aims to distinguish between the available non-invasive imaging techniques in detecting signs of functional and perfusion viability and identify those which have the most clinical relevance in detecting myocardial viability in patients with CAD and chronic ischemic LV dysfunction. The most current available studies showed that both myocardial perfusion and function based on non-invasive imaging have high sensitivity with however wide range of specificity for detecting myocardial viability. Both perfusion and function imaging modalities provide complementary information about myocardial viability and no optimum single imaging technique exists that can provide very accurate diagnostic and prognostic viability assessment. The weight of the body of evidence suggested that non-invasive imaging can help in guiding therapeutic decision making in patients with LV dysfunction.

show abstract

“…Polar viability maps were constructed based using the same 20 segment model as above, and viability defined as wall thickness >6 mm without delayed gadolinium enhancement 14. In areas of borderline wall thickness the segment was judged to be scar if the transmural extent of gadolinium enhancement was >25% 15…”

Section: Cmrmentioning

confidence: 99%

Assessment of Myocardial Scar; Comparison between ¹⁸F-FDG PET, CMR and ⁹⁹Tc-Sestamibi

Crean

Khan

Davies

et al. 2009

Clinical medicine. Cardiology

View full text Add to dashboard Cite

Objective: Patients with heart failure and ischaemic heart disease may obtain benefit from revascularisation if viable dysfunctional myocardium is present. Such patients have an increased operative risk, so it is important to ensure that viability is correctly identified. In this study, we have compared the utility of 3 imaging modalities to detect myocardial scar.Design: Prospective, descriptive study. Setting: Tertiary cardiac centre.Patients: 35 patients (29 male, average age 70 years) with coronary artery disease and symptoms of heart failure (NYHA class II). Outcome Measure: The presence or absence of scar using a 20-segment model. Intervention: Assessment of myocardial scar by Results:More segments were identified as nonviable scar using MIBI than with FDG or CMR. FDG identified the least number of scar segments per patient (7.4 +/-4.8 with MIBI vs. 4.9 +/-4.2 with FDG vs. 5.8 +/-5.0 with CMR, p = 0.0001 by ANOVA). The strongest agreement between modalities was in the anterior wall with the weakest agreement in the inferior wall. Overall, the agreement between modalities was moderate to good. Conclusion:There is considerable variation amongst these 3 techniques in identifying scarred myocardium in patients with coronary disease and heart failure. MIBI and CMR identify more scar than FDG. We recommend that MIBI is not used as the sole imaging modality in patients undergoing assessment of myocardial viability.

show abstract

End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation

Cited by 170 publications

References 35 publications

Taxonomy of segmental myocardial systolic dysfunction

Taxonomy of segmental myocardial systolic dysfunction

Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion

Assessment of Myocardial Scar; Comparison between ¹⁸F-FDG PET, CMR and ⁹⁹Tc-Sestamibi

Contact Info

Product

Resources

About

End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation

Cited by 170 publications

References 35 publications

Taxonomy of segmental myocardial systolic dysfunction

Taxonomy of segmental myocardial systolic dysfunction

Non-invasive imaging in detecting myocardial viability: Myocardial function versus perfusion

Assessment of Myocardial Scar; Comparison between 18F-FDG PET, CMR and 99Tc-Sestamibi

Contact Info

Product

Resources

About

Assessment of Myocardial Scar; Comparison between ¹⁸F-FDG PET, CMR and ⁹⁹Tc-Sestamibi