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Cardiology Research and Practice
Volume 2012, Article ID 607486, 13 pages
Review Article

Myocardial Viability: What We Knew and What Is New

1The Department of Clinical Medicine, Weill Cornell Medical College, P.O. Box 24144, Doha, Qatar
2The Department of Cardiology, Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
3Clinical Research, Trauma Surgery Unit, Hamad General Hospital, P.O. Box 3050, Doha, Qatar

Received 11 April 2012; Revised 29 May 2012; Accepted 9 June 2012

Academic Editor: H. A. Katus

Copyright © 2012 Adel Shabana and Ayman El-Menyar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Some patients with chronic ischemic left ventricular dysfunction have shown significant improvements of contractility with favorable long-term prognosis after revascularization. Several imaging techniques are available for the assessment of viable myocardium, based on the detection of preserved perfusion, preserved glucose metabolism, intact cell membrane and mitochondria, and presence of contractile reserve. Nuclear cardiology techniques, dobutamine echocardiography and positron emission tomography are used to assess myocardial viability. In recent years, new advances have improved methods of detecting myocardial viability. This paper summarizes the pathophysiology, methods, and impact of detection of myocardial viability, concentrating on recent advances in such methods. We reviewed the literature using search engines MIDLINE, SCOUPS, and EMBASE from 1988 to February 2012. We used key words: myocardial viability, hibernation, stunning, and ischemic cardiomyopathy. Recent studies showed that the presence of viable myocardium was associated with a greater likelihood of survival in patients with coronary artery disease and LV dysfunction, but the assessment of myocardial viability did not identify patients with survival benefit from revascularization, as compared with medical therapy alone. This topic is still debatable and needs more evidence.