MYOCARDIAL VIABILITY - STRESS ECHOCARDIOGRAPHY VS NUCLEAR-MEDICINE

Myocardial dyssynergy does not necessarily indicate myocardial necrosi s in patients with coronary artery disease. The differentiation betwee n viable and non-viable tissue is of great clinical importance in orde r to make the most appropriate clinical decision in the individual pat ient. Several techniques are used to assess myocardial viability. Nucl ear medicine gives reliable information on regional perfusion, metabol ism and cell membrane integrity, while echocardiography provides real time visualization of myocardial thickening in basal conditions and co ntinuously during pharmacological interventions. The presence or absen ce of contractile reserve in akinetic regions can be evaluated by phar macological stress echocardiography. This article presents the semiolo gy of myocardial viability as characterized by these different methods and reviews their relative value in different clinical settings.