Frontiers in Myocardia

Volume: 2

Myocardial Viability Assessment in Predicting Prognosis and Providing Optimal Management for Ischemic Left Ventricular Dysfunction

Author(s): Tokuo Kasai

Pp: 29-56 (28)

DOI: 10.2174/9781681087603118020006

* (Excluding Mailing and Handling)

Abstract

After the Surgical Treatment for Ischemic Heart Failure (STICH) trial was introduced, it is controversial whether myocardial viability assessment is necessary or not. Myocardial viability assessment has been regarded as an essential element to select candidates for revascularization who will benefit from revascularization. However, viability determination failed to identify the patients with a differential survival benefit from CABG as compared with medical therapy alone from the sub-study of STICH trial. F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) assisted management for patients with severe left ventricular (LV) dysfunction and suspected coronary artery disease (CAD) also failed to demonstrate a significant reduction in cardiac events compared with standard care (PARR-2 study). However, a significant benefit was observed when there was adherence to PET analysis is limited to PET recommendations. Like this, when the negative report is interpreted carefully, viability assessment can assign the right patients for the right treatment. To assess viability, concomitant myocardial jeopardy is essential to evaluate. Endpoints for viability assessment were regional/global functional recovery, symptom relief, exercise capacity improvement, reduction of re-hospitalization rate, and prevention of LV remodeling after revascularization. Some beneficial effects can be obtained in patients with ischemic LV dysfunction in the presence of viability even if functional recovery was not demonstrated. The importance of viability assessment and the similarities and differences of imaging modalities are discussed in this chapter.


Keywords: FDG-PET, Functional Recovery, Jeopardy, MRI, Viability.

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51595851 and j.to_ip >=51595851 )) and ((j.from_date <= 1740362319 and j.to_date >= 1740362319 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12766) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51595851 and j.to_ip >=51595851 )) and ((j.from_date <= 1740362319 and j.to_date >= 1740362319 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12766) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 51595851 and j.to_ip >=51595851 )) and ((j.from_date <= 1740362319 and j.to_date >= 1740362319 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 12766)
      520μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 2631 and `b`.`banner_from_date` <= 1740362319 and `b`.`banner_to_date` >= 1740362319 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.05msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 2631
      • 3: 1740362319
      • 4: 1740362319
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='027e94ccbfcdef003644a351e27b22c8'
      190μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    5Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        IoXNfIvGbUXzM31I1Hqt1PlB3vGT9BC0zZg4J35Y
        uc_cart_id
        027e94ccbfcdef003644a351e27b22c8
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12766" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/12766
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
        array:17 [ "x-https" => array:1 [ 0 => "1" ] "host" => array:1 [ 0 => "alpha.eurekaselect.com" ] "priority" => array:1 [ 0 => "u=0, i" ] "cookie" => array:1 [ 0 => "wayfindertarget=eyJpdiI6IlBuc3hXVmppZTEvK3B5TFRwNGhQekE9PSIsInZhbHVlIjoiaDRlZ3NSc0Y2ZFV1KzQzemZDUHFpZDNVV2NBTTZLbXp5UTU4VVVwdjZZND0iLCJtYWMiOiJiZmYxMDUzY2ZlNGY0Mjc4ZDk3Mzc0MmJkNzg2Yjc1Y2VmMTMwOTJiM2JhNzAwMzhiNDM2NDQ4MTVkNDE4YWFlIiwidGFnIjoiIn0%3Dwayfindertarget=eyJpdiI6IlBuc3hXVmppZTEvK3B5TFRwNGhQekE9PSIsInZhbHVlIjoiaDRlZ3NSc0Y2ZFV1KzQzemZDUHFpZDNVV2NBTTZLbXp5UTU4VVVwdjZZND0iLCJtYWMiOiJiZmYxMDUzY2ZlNGY0" ] "accept-encoding" => array:1 [ 0 => "gzip, deflate, br, zstd" ] "sec-fetch-dest" => array:1 [ 0 => "document" ] "sec-fetch-user" => array:1 [ 0 => "?1" ] "sec-fetch-mode" => array:1 [ 0 => "navigate" ] "sec-fetch-site" => array:1 [ 0 => "none" ] "accept" => array:1 [ 0 => "text/html,application/xhtml+xml,application/xml;q=0.9,image/avif,image/webp,image/apng,*/*;q=0.8,application/signed-exchange;v=b3;q=0.7" ] "user-agent" => array:1 [ 0 => "Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)" ] "upgrade-insecure-requests" => array:1 [ 0 => "1" ] "sec-ch-ua-platform" => array:1 [ 0 => ""Windows"" ] "sec-ch-ua-mobile" => array:1 [ 0 => "?0" ] "sec-ch-ua" => array:1 [ 0 => ""HeadlessChrome";v="129", "Not=A?Brand";v="8", "Chromium";v="129"" ] "cache-control" => array:1 [ 0 => "no-cache" ] "pragma" => array:1 [ 0 => "no-cache" ] ]
        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 24 Feb 2025 01:58:39 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkFVRzRvTExwTldMM2FSeXZ5a09VaVE9PSIsInZhbHVlIjoiT05lQ3FCR1p1dk1MSUdVSlZacWw4TGxLZ1JUZ092a3FtRURoYkc3TGZmMURzNFViTEtmQXBMRUU3NndqRUY1aW16RXEzbFVFUm9Mbmk1QzZlR1M5YWhpNkIwTFA4eUEzbzl4R2NtRGxuMjZueFpQbFNRZUZMTllFWmRWRWFaNWsiLCJtYWMiOiIxNmRjZTFmNDU4ODAxNTI3ZjI0NDU1MjZkNDNlMGU4MTY5YzFjYmQ4Zjk3ODcwMGVkNmUwOWZiOGVjNTA4OWYwIiwidGFnIjoiIn0%3D; expires=Wed, 26 Feb 2025 13:58:39 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkFVRzRvTExwTldMM2FSeXZ5a09VaVE9PSIsInZhbHVlIjoiT05lQ3FCR1p1dk1MSUdVSlZacWw4TGxLZ1JUZ092a3FtRURoYkc3TGZmMURzNFViTEtmQXBMRUU3NndqRUY1aW16RXEzb" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlpHVXhBcVFtOFFyR00vTXh0OHFoRlE9PSIsInZhbHVlIjoiSW5XY0ZpYkdrK0JzS051MVZmNXE3c1A2U1JHQ3pQR2Q4SjUyRzJVMXZKcDRFUEkwcWhXUW5pc2tzUGV2bTdieVBSVlFJU2JDUG9LUFlCU2ZrU3duRnVBRCthYm1kNW5xSkVFbWZLQ3dmdVBLZVNtSUtvQWJaTG1aWURSelRBT2siLCJtYWMiOiJhZDU2YWZhODM0MGFiNDU2MTdiOWIzNGQ2NmQzZmNjZmY1Y2Q0MWUyYjNjMjdjZDVmMjYxM2UyM2UxNTlhYzc2IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6IlpHVXhBcVFtOFFyR00vTXh0OHFoRlE9PSIsInZhbHVlIjoiSW5XY0ZpYkdrK0JzS051MVZmNXE3c1A2U1JHQ3pQR2Q4SjUyRzJVMXZKcDRFUEkwcWhXUW5pc2t" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkFVRzRvTExwTldMM2FSeXZ5a09VaVE9PSIsInZhbHVlIjoiT05lQ3FCR1p1dk1MSUdVSlZacWw4TGxLZ1JUZ092a3FtRURoYkc3TGZmMURzNFViTEtmQXBMRUU3NndqRUY1aW16RXEzbFVFUm9Mbmk1QzZlR1M5YWhpNkIwTFA4eUEzbzl4R2NtRGxuMjZueFpQbFNRZUZMTllFWmRWRWFaNWsiLCJtYWMiOiIxNmRjZTFmNDU4ODAxNTI3ZjI0NDU1MjZkNDNlMGU4MTY5YzFjYmQ4Zjk3ODcwMGVkNmUwOWZiOGVjNTA4OWYwIiwidGFnIjoiIn0%3D; expires=Wed, 26-Feb-2025 13:58:39 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkFVRzRvTExwTldMM2FSeXZ5a09VaVE9PSIsInZhbHVlIjoiT05lQ3FCR1p1dk1MSUdVSlZacWw4TGxLZ1JUZ092a3FtRURoYkc3TGZmMURzNFViTEtmQXBMRUU3NndqRUY1aW16RXEzb" 1 => "alphaeurekaselectnet_session=eyJpdiI6IlpHVXhBcVFtOFFyR00vTXh0OHFoRlE9PSIsInZhbHVlIjoiSW5XY0ZpYkdrK0JzS051MVZmNXE3c1A2U1JHQ3pQR2Q4SjUyRzJVMXZKcDRFUEkwcWhXUW5pc2tzUGV2bTdieVBSVlFJU2JDUG9LUFlCU2ZrU3duRnVBRCthYm1kNW5xSkVFbWZLQ3dmdVBLZVNtSUtvQWJaTG1aWURSelRBT2siLCJtYWMiOiJhZDU2YWZhODM0MGFiNDU2MTdiOWIzNGQ2NmQzZmNjZmY1Y2Q0MWUyYjNjMjdjZDVmMjYxM2UyM2UxNTlhYzc2IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6IlpHVXhBcVFtOFFyR00vTXh0OHFoRlE9PSIsInZhbHVlIjoiSW5XY0ZpYkdrK0JzS051MVZmNXE3c1A2U1JHQ3pQR2Q4SjUyRzJVMXZKcDRFUEkwcWhXUW5pc2t" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "IoXNfIvGbUXzM31I1Hqt1PlB3vGT9BC0zZg4J35Y" "uc_cart_id" => "027e94ccbfcdef003644a351e27b22c8" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/12766" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-24 01:58:39GET/chapter/12766112197