الفهرس | Only 14 pages are availabe for public view |
Abstract Ischemic heart disease has been the commonest cause of premature death and acute medical admission to hospital in developed countries for many years. The most serious manifestation of myocardial ischemia is contractile dysfunction where left ventricular function is the main determinant of long-term survival in patients with ischemic heart disease. Several treatment options are available for patients with ischaemic cardiomyopathy and treatment needs to be tailored to the individual patient. Available treatment choices include medical therapy, cardiac transplantation and myocardial revascularization (coronary artery bypass surgery (CABG) or percutaneous transluminal coronary angioplasty (PTCA)). Myocardial revascularization is an effective option for patients with viable myocardium where it can improve ventricular dysfunction and long-term survival, whereas revascularization in patients with predominantly nonviable myocardium exposes the patient to the unnecessary risk of invasive procedures and mortality. (Schinkel et al, 2005 and Lardo et al, 2006) Therefore distinguishing dysfunctional but viable myocardium from nonviable tissue after acute or chronic ischemia has important implications for the therapeutic management of patients with coronary artery disease. Several noninvasive radiological imaging modalities are able to identify dysfunctional but viable tissue: echocardiography, single photon emission computed tomography (SPECT) imaging, positron emission tomography (PET) and Magnetic Resonance Imaging (MRI. |