Current Problems in Cardiology
Volume 32, Issue 7 , Pages 375-410 , July 2007

Hibernating Myocardium: Diagnosis and Patient Outcomes

References 

  1. Bax JJ, Poldermans D, Elhendy A, et al. Sensitivity, specificity, and predictive accuracies of various noninvasive techniques for detecting hibernating myocardium. Curr Probl Cardiol. 2001;26:147–186
  2. Dellegrottaglie S, Perrone-Filardi P, Pace L, et al. Prediction of long-term effects of revascularization on regional and global left ventricular function by dobutamine echocardiography and rest Tl-201 imaging alone and in combination in patients with chronic coronary artery disease. J Nucl Cardiol. 2002;9:174–182
  3. Leoncini M, Sciagra R, Bellandi F, et al. Low-dose dobutamine nitrate-enhanced technetium 99m sestamibi gated SPECT versus low-dose dobutamine echocardiography for detecting reversible dysfunction in ischemic cardiomyopathy. J Nucl Cardiol. 2002;9:402–406
  4. Piscione F, De Luca G, Perrone-Filardi P, et al. Relationship between contractile reserve, Tl-201 uptake, and collateral angiographic circulation in collateral-dependent myocardium: implications regarding the evaluation of myocardial viability. J Nucl Cardiol. 2003;10:17–27
  5. Piscione F, Perrone-Filardi P, De Luca G, et al. Low dose dobutamine echocardiography for predicting functional recovery after coronary revascularisation. Heart. 2001;86:679–686
  6. Pace L, Filardi PP, Cuocolo A, et al. Diagnostic accuracy of low-dose dobutamine echocardiography in predicting post-revascularisation recovery of function in patients with chronic coronary artery disease: relationship to thallium-201 uptake. Eur J Nucl Med. 2001;28:1616–1623
  7. Cwajg JM, Cwajg E, Nagueh SF, et al. End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation: relation to rest-redistribution T1-201 tomography and dobutamine stress echocardiography. J Am Coll Cardiol. 2000;35:1152–1161
  8. Ling LH, Christian TF, Mulvagh SL, et al. Determining myocardial viability in chronic ischemic left ventricular dysfunction: a prospective comparison of rest-redistribution thallium 201 single-photon emission computed tomography, nitroglycerin-dobutamine echocardiography, and intracoronary myocardial contrast echocardiography. Am Heart J. 2006;151:882–889
  9. Hanekom L, Jenkins C, Jeffries L, et al. Incremental value of strain rate analysis as an adjunct to wall-motion scoring for assessment of myocardial viability by dobutamine echocardiography: a follow-up study after revascularization. Circulation. 2005;112:3892–3900
  10. Zaglavara T, Karvounis HI, Haaverstad R, et al. Dobutamine stress echocardiography is highly accurate for the prediction of contractile reserve in the early postoperative period, but may underestimate late recovery in contractile reserve after revascularization of the hibernating myocardium. J Am Soc Echocardiogr. 2006;19:300–306
  11. Cwajg JM, Cwajg E, Nagueh SF, et al. End-diastolic wall thickness as a predictor of recovery of function in myocardial hibernation: relation to rest-redistribution T1-201 tomography and dobutamine stress echocardiography. J Am Coll Cardiol. 2000;35:1152–1161
  12. Duncan BH, Ahlberg AW, Levine MG, et al. Comparison of electrocardiographic-gated technetium-99m sestamibi single-photon emission computed tomographic imaging and rest-redistribution thallium-201 in the prediction of myocardial viability. Am J Cardiol. 2000;85:680–684
  13. Ling LH, Christian TF, Mulvagh SL, et al. Determining myocardial viability in chronic ischemic left ventricular dysfunction: a prospective comparison of rest-redistribution thallium 201 single-photon emission computed tomography, nitroglycerin-dobutamine echocardiography, and intracoronary myocardial contrast echocardiography. Am Heart J. 2006;151:882–889
  14. Wu YW, Huang PJ, Lee CM, et al. Assessment of myocardial viability using F-18 fluorodeoxyglucose/Tc-99m sestamibi dual-isotope simultaneous acquisition SPECT: comparison with Tl-201 stress-reinjection SPECT. J Nucl Cardiol. 2005;12:451–459
  15. Gonzalez JM, Castell-Conesa J, Candell-Riera J, et al. Spanish Working Group of Nuclear Cardiology (Relevance of 99mTc-MIBI rest uptake, ejection fraction and location of contractile abnormality in predicting myocardial recovery after revascularization). Nucl Med Commun. 2001;22:795–805
  16. Mabuchi M, Kubo N, Morita K, et al. Prediction of functional recovery after coronary bypass surgery using quantitative gated myocardial perfusion SPECT. Nucl Med Commun. 2003;24:625–631
  17. Murashita T, Makino Y, Kamikubo Y, et al. Quantitative gated myocardial perfusion single photon emission computed tomography improves the prediction of regional functional recovery in akinetic areas after coronary bypass surgery: useful tool for evaluation of myocardial viability. J Thorac Cardiovasc Surg. 2003;126:1328–1334
  18. Slart RH, Bax JJ, van Veldhuisen DJ, et al. Prediction of functional recovery after revascularization in patients with chronic ischaemic left ventricular dysfunction: head-to-head comparison between (99m)Tc-sestamibi/(18)F-FDG DISA SPECT and (13)N-ammonia/(18)F-FDG PET. Eur J Nucl Med Mol Imaging. 2006;33:716–723
  19. Nowak B, Schaefer WM, Koch KC, et al. Assessment of myocardial viability in dysfunctional myocardium by resting myocardial blood flow determined with oxygen 15 water PET. J Nucl Cardiol. 2003;10:34–45
  20. Schmidt M, Voth E, Schneider CA, et al. F-18-FDG uptake is a reliable predictory of functional recovery of akinetic but viable infarct regions as defined by magnetic resonance imaging before and after revascularization. Magn Reson Imaging. 2004;22:229–236
  21. Kuhl HP, Lipke CS, Krombach GA, et al. Assessment of reversible myocardial dysfunction in chronic ischaemic heart disease: comparison of contrast-enhanced cardiovascular magnetic resonance and a combined positron emission tomography-single photon emission computed tomography imaging protocol. Eur Heart J. 2006;27:846–853
  22. Baer FM, Theissen P, Schneider CA, et al. Dobutamine magnetic resonance imaging predicts contractile recovery of chronically dysfunctional myocardium after successful revascularization. J Am Coll Cardiol. 1998;31:1040–1048
  23. Klow NE, Smith HJ, Gullestad L, et al. Outcome of bypass surgery in patients with chronic ischemic left ventricular dysfunction (Predictive value of MR imaging). Acta Radiol. 1997;38:76–82
  24. Baer FM, Theissen P, Crnac J, et al. Head to head comparison of dobutamine-transoesophageal echocardiography and dobutamine-magnetic resonance imaging for the prediction of left ventricular functional recovery in patients with chronic coronary artery disease. Eur Heart J. 2000;21:981–991
  25. Gunning MG, Anagnostopoulos C, Knight CJ, et al. Comparison of 201Tl, 99mTc-tetrofosmin, and dobutamine magnetic resonance imaging for identifying hibernating myocardium. Circulation. 1998;98:1869–1874
  26. Sayad DE, Willett DL, Hundley WG, et al. Dobutamine magnetic resonance imaging with myocardial tagging quantitatively predicts improvement in regional function after revascularization. Am J Cardiol. 1998;82:1149–1151
  27. Sandstede JJ, Bertsch G, Beer M, et al. Detection of myocardial viability by low-dose dobutamine Cine MR imaging. Magn Reson Imaging. 1999;17:1437–1443
  28. Trent RJ, Waiter GD, Hillis GS, et al. Dobutamine magnetic resonance imaging as a predictor of myocardial functional recovery after revascularisation. Heart. 2000;83:40–46
  29. Wellnhofer E, Olariu A, Klein C, et al. Magnetic resonance low-dose dobutamine test is superior to SCAR quantification for the prediction of functional recovery. Circulation. 2004;109:2172–2174
  30. Van Hoe L, Vanderheyden M. Ischemic cardiomyopathy: value of different MRI techniques for prediction of functional recovery after revascularization. AJR Am J Roentgenol. 2004;182:95–100
  31. Kim RJ, Wu E, Rafael A, et al. The use of contrast-enhanced magnetic resonance imaging to identify reversible myocardial dysfunction. N Engl J Med. 2000;343:1445–1453
  32. Selvanayagam JB, Kardos A, Francis JM, et al. Value of delayed-enhancement cardiovascular magnetic resonance imaging in predicting myocardial viability after surgical revascularization. Circulation. 2004;110:1535–1541
  33. Wiggers H, Egeblad H, Nielsen TT, et al. Prediction of reversible myocardial dysfunction by positron emission tomography, low-dose dobutamine echocardiography, resting ECG, and exercise testing. Cardiology. 2001;96:32–37
  34. Carluccio E, Biagioli P, Alunni G, et al. Patients with hibernating myocardium show altered left ventricular volumes and shape, which revert after revascularization: evidence that dyssynergy might directly induce cardiac remodeling. J Am Coll Cardiol. 2006;47:969–977
  35. Petrasinovic Z, Ostojic M, Beleslin B, et al. Prognostic value of myocardial viability determined by a 201Tl SPECT study in patients with previous myocardial infarction and mild-to-moderate myocardial dysfunction. Nucl Med Commun. 2003;24:175–181
  36. Wu YW, Huang PJ, Lee CM, et al. Assessment of myocardial viability using F-18 fluorodeoxyglucose/Tc-99m sestamibi dual-isotope simultaneous acquisition SPECT: comparison with Tl-201 stress-reinjection SPECT. J Nucl Cardiol. 2005;12:451–459
  37. Gursurer M, Emre A, Gercekoglu H, et al. Long-term prognostic value of stress-redistribution-reinjection Tl-201 imaging in patients with severe left ventricular dysfunction and coronary artery bypass surgery. Int J Cardiovasc Imaging. 2002;18:125–133
  38. Leoncini M, Sciagra R, Maioli M, et al. Usefulness of dobutamine Tc-99m sestamibi-gated single-photon emission computed tomography for prediction of left ventricular ejection fraction outcome after coronary revascularization for ischemic cardiomyopathy. Am J Cardiol. 2002;89:817–821
  39. Sciagra R, Leoncini M, Marcucci G, et al. Technetium-99m sestamibi imaging to predict left ventricular ejection fraction outcome after revascularisation in patients with chronic coronary artery disease and left ventricular dysfunction: comparison between baseline and nitrate-enhanced imaging. Eur J Nucl Med. 2001;28:680–687
  40. Gerber BL, Ordoubadi FF, Wijns W, et al. Positron emission tomography using(18)F-fluoro-deoxyglucose and euglycaemic hyperinsulinaemic glucose clamp: optimal criteria for the prediction of recovery of post-ischaemic left ventricular dysfunction (Results from the European Community Concerted Action Multicenter study on use of(18)F-fluoro-deoxyglucose Positron Emission Tomography for the Detection of Myocardial Viability). Eur Heart J. 2001;22:1691–1701
  41. Tillisch J, Brunken R, Marshall R, et al. Reversibility of cardiac wall-motion abnormalities predicted by positron tomography. N Engl J Med. 1986;314:884–888
  42. Lucignani G, Paolini G, Landoni C, et al. Presurgical identification of hibernating myocardium by combined use of technetium-99m hexakis 2-methoxyisobutylisonitrile single photon emission tomography and fluorine-18 fluoro-2-deoxy-D-glucose positron emission tomography in patients with coronary artery disease. Eur J Nucl Med. 1992;19:874–881
  43. Marwick TH, Nemec JJ, Lafont A, et al. Prediction by postexercise fluoro-18 deoxyglucose positron emission tomography of improvement in exercise capacity after revascularization. Am J Cardiol. 1992;69:854–859
  44. Maes A, Flameng W, Nuyts J, et al. Histological alterations in chronically hypoperfused myocardium (Correlation with PET findings). Circulation. 1994;90:735–745
  45. Dreyfus GD, Duboc D, Blasco A, et al. Myocardial viability assessment in ischemic cardiomyopathy: benefits of coronary revascularization. Ann Thorac Surg. 1994;57:1402–1408
  46. Depre C, Vanoverschelde JL, Melin JA, et al. Structural and metabolic correlates of the reversibility of chronic left ventricular ischemic dysfunction in humans. Am J Physiol. 1995;268:H1265–H1275
  47. Maes AF, Borgers M, Flameng W, et al. Assessment of myocardial viability in chronic coronary artery disease using technetium-99m sestamibi SPECT (Correlation with histologic and positron emission tomographic studies and functional follow-up). J Am Coll Cardiol. 1997;29:62–68
  48. Haas F, Haehnel CJ, Picker W, et al. Preoperative positron emission tomographic viability assessment and perioperative and postoperative risk in patients with advanced ischemic heart disease. J Am Coll Cardiol. 1997;30:1693–1700
  49. vom Dahl J, Altehoefer C, Sheehan FH, et al. Recovery of regional left ventricular dysfunction after coronary revascularization (Impact of myocardial viability assessed by nuclear imaging and vessel patency at follow-up angiography). J Am Coll Cardiol. 1996;28:948–958
  50. Schwarz ER, Schoendube FA, Kostin S, et al. Prolonged myocardial hibernation exacerbates cardiomyocyte degeneration and impairs recovery of function after revascularization. J Am Coll Cardiol. 1998;31:1018–1026
  51. Beanlands RS, Hendry PJ, Masters RG, et al. Delay in revascularization is associated with increased mortality rate in patients with severe left ventricular dysfunction and viable myocardium on fluorine 18-fluorodeoxyglucose positron emission tomography imaging. Circulation. 1998;98(suppl 19):II51–II56
  52. Zhang X, Liu XJ, Wu Q, et al. Clinical outcome of patients with previous myocardial infarction and left ventricular dysfunction assessed with myocardial (99m)Tc-MIBI SPECT and (18)F-FDG PET. J Nucl Med. 2001;42:1166–1173
  53. Maes A, Flameng W, Borgers M, et al. Regional myocardial blood flow, glucose utilization and contractile function before and after revascularization and ultrastructural findings in patients with chronic coronary artery disease. Eur J Nucl Med. 1995;22:1299–1305
  54. Bax JJ, Poldermans D, Elhendy A, et al. Improvement of left ventricular ejection fraction, heart failure symptoms and prognosis after revascularization in patients with chronic coronary artery disease and viable myocardium detected by dobutamine stress echocardiography. J Am Coll Cardiol. 1999;34:163–169
  55. Gunning MG, Chua TP, Harrington D, et al. Hibernating myocardium: clinical and functional response to revascularisation. Eur J Cardiothorac Surg. 1997;11:1105–1112
  56. Mule JD, Bax JJ, Zingone B, et al. The beneficial effect of revascularization on jeopardized myocardium: reverse remodeling and improved long-term prognosis. Eur J Cardiothorac Surg. 2002;22:426–430
  57. Chikamori T, Hirose K, Hamada T, et al. Functional recovery after coronary artery bypass grafting in patients with severe left ventricular dysfunction and preserved myocardial viability in the left anterior descending arterial territory as assessed by thallium-201 myocardial perfusion imaging. Jpn Circ J. 1999;63:752–758
  58. Marwick TH, Zuchowski C, Lauer MS, et al. Functional status and quality of life in patients with heart failure undergoing coronary bypass surgery after assessment of myocardial viability. J Am Coll Cardiol. 1999;33:750–758
  59. Di Carli MF, Asgarzadie F, Schelbert HR, et al. Quantitative relation between myocardial viability and improvement in heart failure symptoms after revascularization in patients with ischemic cardiomyopathy. Circulation. 1995;92:3436–3444
  60. Meluzin J, Cerny J, Frelich M, et al. Prognostic value of the amount of dysfunctional but viable myocardium in revascularized patients with coronary artery disease and left ventricular dysfunction (Investigators of this Multicenter Study). J Am Coll Cardiol. 1998;32:912–920
  61. Afridi I, Grayburn PA, Panza JA, et al. Myocardial viability during dobutamine echocardiography predicts survival in patients with coronary artery disease and severe left ventricular systolic dysfunction. J Am Coll Cardiol. 1998;32:921–926
  62. Anselmi M, Golia G, Cicoira M, et al. Prognostic value of detection of myocardial viability using low-dose dobutamine echocardiography in infarcted patients. Am J Cardiol. 1998;81:21–28G
  63. Senior R, Kaul S, Lahiri A. Myocardial viability on echocardiography predicts long-term survival after revascularization in patients with ischemic congestive heart failure. J Am Coll Cardiol. 1999;33:1848–1854
  64. Chaudhry FA, Tauke JT, Alessandrini RS, et al. Prognostic implications of myocardial contractile reserve in patients with coronary artery disease and left ventricular dysfunction. J Am Coll Cardiol. 1999;34:730–738
  65. Meluzin J, Cerny J, Spinarova L, et al. Prognosis of patients with chronic coronary artery disease and severe left ventricular dysfunction (The importance of myocardial viability). Eur J Heart Fail. 2003;5:85–93
  66. Sicari R, Picano E, Cortigiani L, et al. VIDA (Viability Identification with Dobutamine Administration) Study Group Prognostic value of myocardial viability recognized by low-dose dobutamine echocardiography in chronic ischemic left ventricular dysfunction. Am J Cardiol. 2003;92:1263–1266
  67. Rambaldi R, Bax JJ, Rizzello V, et al. Post-systolic shortening during dobutamine stress echocardiography predicts cardiac survival in patients with severe left ventricular dysfunction. Coron Artery Dis. 2005;16:141–145
  68. Rizzello V, Poldermans D, Schinkel AFL, et al. Long term prognostic value of myocardial viability and ischaemia during dobutamine stress echocardiography in patients with ischaemic cardiomyopathy undergoing coronary revascularisation. Heart. 2006;92:239–244
  69. Gioia G, Milan E, Giubbini R, et al. Prognostic value of tomographic rest-redistribution thallium 201 imaging in medically treated patients with coronary artery disease and left ventricular dysfunction. J Nucl Cardiol. 1996;3:150–156
  70. Pagley PR, Beller GA, Watson DD, et al. Improved outcome after coronary bypass surgery in patients with ischemic cardiomyopathy and residual myocardial viability. Circulation. 1997;96:793–800
  71. Cuocolo A, Petretta M, Nicolai E, et al. Successful coronary revascularization improves prognosis in patients with previous myocardial infarction and evidence of viable myocardium at thallium-201 imaging. Eur J Nucl Med. 1998;25:60–68
  72. Zafrir N, Leppo JA, Reinhardt CP, et al. Thallium reinjection versus standard stress/delay redistribution imaging for prediction of cardiac events. J Am Coll Cardiol. 1998;31:1280–1285
  73. Pasquet A, Robert A, D’Hondt AM, et al. Prognostic value of myocardial ischemia and viability in patients with chronic left ventricular ischemic dysfunction. Circulation. 1999;100:141–148
  74. Senior R, Kaul S, Raval U, et al. Impact of revascularization and myocardial viability determined by nitrate-enhanced Tc-99m sestamibi and Tl-201 imaging on mortality and functional outcome in ischemic cardiomyopathy. J Nucl Cardiol. 2002;9:454–462
  75. Eitzman D, al-Aouar Z, Kanter HL, et al. Clinical outcome of patients with advanced coronary artery disease after viability studies with positron emission tomography. J Am Coll Cardiol. 1992;20:559–565
  76. Yoshida K, Gould KL. Quantitative relation of myocardial infarct size and myocardial viability by positron emission tomography to left ventricular ejection fraction and 3-year mortality with and without revascularization. J Am Coll Cardiol. 1993;22:984–997
  77. Di Carli MF, Davidson M, Little R, et al. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1994;73:527–533
  78. Lee KS, Marwick TH, Cook SA, et al. Prognosis of patients with left ventricular dysfunction, with and without viable myocardium after myocardial infarction (Relative efficacy of medical therapy and revascularization). Circulation. 1994;90:2687–2694
  79. vom Dahl J, Altehoefer C, Sheehan FH, et al. Effect of myocardial viability assessed by technetium-99m-sestamibi SPECT and fluorine-18-FDG PET on clinical outcome in coronary artery disease. J Nucl Med. 1997;38:742–748
  80. Di Carli MF, Maddahi J, Rokhsar S, et al. Long-term survival of patients with coronary artery disease and left ventricular dysfunction: implications for the role of myocardial viability assessment in management decisions. J Thorac Cardiovasc Surg. 1998;116:997–1004
  81. Pagano D, Lewis ME, Townend JN, et al. Coronary revascularisation for postischaemic heart failure: how myocardial viability affects survival. Heart. 1999;82:684–688
  82. Desideri A, Cortigiani L, Christen AI, et al. The extent of perfusion-F18-fluorodeoxyglucose positron emission tomography mismatch determines mortality in medically treated patients with chronic ischemic left ventricular dysfunction. J Am Coll Cardiol. 2005;46:1264–1269
  83. Bax JJ, Poldermans D, Schinkel AFL, et al. Perfusion and contractile reserve in chronic dysfunctional myocardium: relation to functional outcome after surgical revascularization. Circulation. 2002;106(12 suppl 1):I14–I18
  84. Schinkel AFL, Poldermans D, Rizzello V, et al. Why do patients with ischemic cardiomyopathy and a substantial amount of viable myocardium not always recover in function after revascularization?. J Thorac Cardiovasc Surg. 2004;127:385–390
  85. Bax JJ, Schinkel AFL, Boersma E, et al. Extensive left ventricular remodeling does not allow viable myocardium to improve in left ventricular ejection fraction after revascularization and is associated with worse long-term prognosis. Circulation. 2004;110(11 suppl 1):II18–II22
  86. Rizzello V, Schinkel AFL, Bax JJ, et al. Individual prediction of functional recovery after coronary revascularization in patients with ischemic cardiomyopathy: the scar-to-biphasic model. Am J Cardiol. 2003;91:1406–1409
  87. Bax JJ, Schinkel AFL, Boersma E, et al. Early versus delayed revascularization in patients with ischemic cardiomyopathy and substantial viability: impact on outcome. Circulation. 2003;108(suppl 1):II39–II42
  88. Rahimtoola SH, La Canna G, Ferrari R. Hibernating myocardium, another piece of the puzzle falls into place. J Am Coll Cardiol. 2006;47:978–980
  89. Bax JJ, Visser FC, Poldermans D, et al. Time course of functional recovery of stunned and hibernating segments after surgical revascularization. Circulation. 2001;104(12 suppl 1):I314–I318
  90. La Canna G, Rahimtoola SH, Visioli O, et al. Sensitivity, specificity, and predictive accuracies of noninvasive tests, singly and in combination for diagnosis of hibernating myocardium. Eur Heart J. 2001;21:1358–1367
  91. Allman KC, Shaw LJ, Hachamovitch R, et al. Myocardial viability testing and impact of revascularization on prognosis in patients with coronary artery disease and left ventricular dysfunction: a meta-analysis. J Am Coll Cardiol. 2002;39:1151–1158

PII: S0146-2806(07)00032-1

doi: 10.1016/j.cpcardiol.2007.04.001

Current Problems in Cardiology
Volume 32, Issue 7 , Pages 375-410 , July 2007

Article Tools

* Image Usage & Resolution