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Cardiology Research and Practice
Volume 2016, Article ID 1020818, 10 pages
http://dx.doi.org/10.1155/2016/1020818
Review Article

Myocardial Viability: From Proof of Concept to Clinical Practice

1Department of Cardiology, Blacktown Hospital, Blacktown Road, Blacktown NSW 2148, Australia
2Western Sydney University, Richmond, NSW, Australia

Received 29 February 2016; Accepted 4 May 2016

Academic Editor: Robert Chen

Copyright © 2016 Aditya Bhat et al. 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.

Abstract

Ischaemic left ventricular (LV) dysfunction can arise from myocardial stunning, hibernation, or necrosis. Imaging modalities have become front-line methods in the assessment of viable myocardial tissue, with the aim to stratify patients into optimal treatment pathways. Initial studies, although favorable, lacked sufficient power and sample size to provide conclusive outcomes of viability assessment. Recent trials, including the STICH and HEART studies, have failed to confer prognostic benefits of revascularisation therapy over standard medical management in ischaemic cardiomyopathy. In lieu of these recent findings, assessment of myocardial viability therefore should not be the sole factor for therapy choice. Optimization of medical therapy is paramount, and physicians should feel comfortable in deferring coronary revascularisation in patients with coronary artery disease with reduced LV systolic function. Newer trials are currently underway and will hopefully provide a more complete understanding of the pathos and management of ischaemic cardiomyopathy.