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Guidelines on myocardial revascularization
The Task Force on Myocardial Revascularization of the European
Society of Cardiology (ESC) and the European Association for
Cardio-Thoracic Surgery (EACTS)
5.6 Detection of myocardial viability
The prognosis of patients with chronic ischaemic systolic LV dysfunction is poor, despite advances in various therapies. Non-invasive assessment of myocardial viability should guide patient management.
Multiple imaging techniques including PET, SPECT, and dobutamine stress echocardiography have been extensively evaluated for assessment of viability and prediction of clinical outcome after myocardialrevascularization.
In general, nuclear imaging techniques have a high sensitivity, whereas techniques evaluating contractile reserve have somewhat lower sensitivity but higher speciﬁcity. MRI has a high diagnostic accuracy to assess transmural extent of myocardial scar tissue, but its ability to detect viability and predict recovery of wall motion is not superior to other imaging techniques.