MYOCARDIAL VIABILITY

Course overview

MYOCARDIAL VIABILITY REFERS TO A PHENOMENON IN WHICH DYSFUNCTIONAL MYOCARDIUM, DUE TO ACUTE OR CHRONIC ISCHEMIA, RETAINS ITS POTENTIAL TO RECOVER SYSTOLIC FUNCTION AFTER REVASCULARIZATION. THE MYOCARDIAL INSULTS SECONDARY TO ACUTE OR CHRONIC ISCHEMIA LEAD NOT ONLY TO IRREVERSIBLE DAMAGE TO THE MYOCARDIUM BUT ALSO ADAPTIVE RESPONSES IN WHICH THE MYOCARDIUM STAYS IN A LATENT STATE IN AN ISCHEMIC MILIEU WITH THE POTENTIAL TO RECOVER UPON REVASCULARIZATION. ASSESSMENT OF MYOCARDIAL VIABILITY IS ESSENTIAL IN PATIENTS WITH CHRONIC ISCHEMIC CARDIOMYOPATHY. IT IS ALSO CRUCIAL IN SYMPTOMATIC PATIENTS WITH CHRONIC TOTAL OCCLUSION OF THE CORONARY ARTERIES AND ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION WITH A LATE PRESENTATION BEFORE CONSIDERING REVASCULARIZATION. LEFT VENTRICULAR EJECTION FRACTION IS ONE OF THE STRONGEST PREDICTORS OF SURVIVAL IN PATIENTS WITH ISCHEMIC CARDIOMYOPATHY. THIS ACTIVITY COVERS THE FUNDAMENTAL ASSESSMENT OF MYOCARDIAL VIABILITY TO IDENTIFY DYSFUNCTIONAL MYOCARDIAL SEGMENTS THAT MAY RECOVER FUNCTIONS WITH REVASCULARIZATION LEADING TO THE PREVENTION OF FURTHER DAMAGE BY ACUTE ISCHEMIC INSULTS, IMPROVEMENT IN SYSTOLIC FUNCTION, AND BETTER PATIENT OUTCOMES.