Faculty of Medicine, Lisbon University, University Hospital Santa Maria/CHLN, Portugal.
Cardiology Department, University Hospitals Dorset, NHS Foundation Trust, Poole Hospital, Longfleet Road, Poole, Dorset BH15 2JB, United Kingdom.
Eur Heart J Cardiovasc Imaging. 2021 Jul 20;22(8):e97-e125. doi: 10.1093/ehjci/jeab053.
In clinical decision making, myocardial viability is defined as myocardium in acute or chronic coronary artery disease and other conditions with contractile dysfunction but maintained metabolic and electrical function, having the potential to improve dysfunction upon revascularization or other therapy. Several pathophysiological conditions may coexist to explain this phenomenon. Cardiac imaging may allow identification of myocardial viability through different principles, with the purpose of prediction of therapeutic response and selection for treatment. This expert consensus document reviews current insight into the underlying pathophysiology and available methods for assessing viability. In particular the document reviews contemporary viability imaging techniques, including stress echocardiography, single photon emission computed tomography, positron emission tomography, cardiovascular magnetic resonance, and computed tomography and provides clinical recommendations for how to standardize these methods in terms of acquisition and interpretation. Finally, it presents clinical scenarios where viability assessment is clinically useful.
在临床决策中，心肌存活定义为急性或慢性冠状动脉疾病及其他伴有收缩功能障碍但代谢和电功能保持的情况下的心肌，具有在血运重建或其他治疗后改善功能的潜力。几种病理生理状况可能同时存在，以解释这种现象。心脏影像学可以通过不同的原理来识别心肌存活，目的是预测治疗反应和选择治疗。本专家共识文件回顾了目前对潜在病理生理学的认识，以及评估存活能力的现有方法。特别是，该文件回顾了当代存活成像技术，包括应激超声心动图、单光子发射计算机断层扫描、正电子发射断层扫描、心血管磁共振和计算机断层扫描，并就如何在获取和解释方面标准化这些方法提供了临床建议。最后，它提出了在哪些临床情况下评估存活能力具有临床意义。
