Gropler R J
Edward Mallinckrodt Institute of Radiology, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110.
AJR Am J Roentgenol. 1993 Sep;161(3):497-500. doi: 10.2214/ajr.161.3.8352093.
One goal of strategies designed to restore nutritive perfusion in patients with left ventricular dysfunction attributable to coronary artery disease is salvage of reversibly ischemic myocardium in an effort to improve patients' left ventricular function, signs and symptoms, and survival. Accurate identification of patients likely to benefit from interventions such as coronary revascularization requires the differentiation of viable (reversibly dysfunctional) myocardium from nonviable (persistently dysfunctional) tissue. To date, no consensus has been reached regarding the best approach for achieving this differentiation. In this review, the pathophysiologic characteristics of viable and nonviable myocardium are summarized, and diagnostic methods that exploit these characteristics for the purposes of detecting viable myocardium are discussed. Emphasis is placed on approaches that use positron emission tomography because of its usefulness in quantifying those specific metabolic processes that support both tissue viability and the capacity for functional recovery.
旨在恢复因冠状动脉疾病导致左心室功能障碍患者营养性灌注的策略，其目标之一是挽救可逆性缺血心肌，以改善患者的左心室功能、体征和症状以及生存率。准确识别可能从冠状动脉血运重建等干预措施中获益的患者，需要区分存活（可逆性功能障碍）心肌和无存活能力（持续性功能障碍）组织。迄今为止，对于实现这种区分的最佳方法尚未达成共识。在本综述中，总结了存活和无存活能力心肌的病理生理特征，并讨论了利用这些特征检测存活心肌的诊断方法。由于正电子发射断层扫描在量化支持组织存活能力和功能恢复能力的特定代谢过程方面的实用性，因此重点介绍了使用该技术的方法。
