[Usefulness of nuclear techniques in the study of myocardial viability].

The assessment of myocardial viability in patients with coronary artery disease and left ventricular dysfunction is of great diagnostic and prognostic value. The identification of myocardial viability, in patients with coronary artery disease and left ventricular dysfunction is useful in risk stratification, for it allows the prediction of a group of patients that may benefit the most from a revascularization procedure. The revascularization of dysfunctional (asinergic) segments showing viability in patients with coronary artery disease and left ventricular dysfunction has been associated to improved survival and New York Heart Association (NYHA) class. An improvement in global as well as in regional left ventricular function has also been described. Currently, several non-invasive imaging techniques have been used to assess myocardial viability, among them, nuclear cardiology methods are the most employed. TI-201 SPECT imaging (stress-redistribution-reinjection) is one of the most commonly used, because of its availability, cost, and correlation with 18-FDG PET studies, which is considered the gold standard among imaging techniques for the detection of myocardial viability. Therefore, if PET is available, it should be used in patients with coronary artery disease and moderate to severe left ventricular dysfunction.