Rational Pharmacotherapy in Cardiology

Advanced search


Full Text:


The main methods of viable myocardium diagnosis in patients with ischemic heart disease are discussed. Сurrent opportunities of stress echocardiography and tissue Doppler echocardiography in viable myocardium detection are presented.

About the Authors

D. N. Perutskiy
St Joasaph Belgorod Regional Clinical Hospital
Russian Federation

T. I. Makeeva
St-Petersburg Medical Academy of Postgraduate Education
Russian Federation

S. L. Konstantinov
St Joasaph Belgorod Regional Clinical Hospital
Russian Federation


1. Alhaddad I.A., Kloner R.A., Hakim I. et al. Benefits of late coronary artery reperfusion on infarct expansion progressively diminish over time: relation to viable islets of myocytes within the scar. Am Heart J 1996;131(3):451-7.

2. Hochman J.S., Bulkley B.H. Expansion of acute myocardial infarction: an experimental study. Circulation 1982;65:1446–50.

3. Pirolo J.S., Hutchins G.M., Moore G.W. Infarct expansion: pathologic analysis of 204 patients with a single myocardial infarct. J Am Coll Cardiol 1986;7:349–54.

4. Bolognese L., Cerisano G., Buonamici P. et al. Influence of Infarct-Zone Viability on Left Ventricular Re-modeling After Acute Myocardial Infarction. Circulation 1997;96:3353-3359.

5. Nijland F., Kamp O., Verhorst P.M. et al. Myocardial viability: impact on left ventricular dilatation after acute myocardial infarction. Heart 2002;87:17-22.

6. Bogaert J., Maes A., Van de Werf F. et all. Functional Recovery of Subepicardial Myocardial Tissue in Transmural Myocardial Infarction After Successful Reperfusion an Important Contribution to the Improvement of Regional and Global Left Ventricular Function. Circulation 1999;99:36-43.

7. Bourdillon P., Broderick T.M., Williams E.S. et al. Early recovery of regional left ventricular function after reperfusion in acute myocardial infarction assessed by serial two-dimensional echocardiography. Am J Cardiol 1989;63:641-646

8. Zoghbi W.A., Marian A., Cheirif J.B. et al. Time course of recovery of regional function following thrombolysis in acute myocardial infarction (TIMI): Preliminary observations for the TIMI trial phase II. (abstract) J Am Coll Cardiol 1990;15:233A

9. Patel B., Kloner R.A., Przyklenk K. et al. Postischemic myocardial "stunning": A clinically relevant phenomenon. Ann Intern Med 1988;108:626-628

10. Sheehan F.H., Mathey D.G., Schofer J. et al. Factors that determine recovery of left ventricular function after thrombolysis in patients with acute myocardial infarction. Circulation 1985;71:1121-1128

11. Bolli R. Myocardial 'stunning' in man. Circulation 1992; 86; 1671-1691

12. Cornel J.H., Bax J.J., Elhendy A. et al. Agreement and disagreement between "metabolic viability" and "contractile reserve" in akinetic myocardium. J Nucl Cardiol 1999;6(4):383–388.

13. Bax J.J., Wijns W., Cornel J.H. et al. Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease: comparison of pooled data. J Am Coll Cardiol 1997;30(6):1451–1460.

14. Litvinov M.M., Prokhorovich I.S., Bochkova I.M. et al. Assessment of myocardial viability by positron emission tomography with rubidium — 82. Meditsinskaya radiologiya i radiatsionnaya bezopasnost' 1997;42(3):13–18. Russian (Литвинов М.М., Прохорович И.С., Бочкова И.М. и соавт. Оценка жизнеспособности миокарда с помощью позитронно–эмиссионной томографии с рубидием — 82. Медицинская радиология и радиационная безопасность 1997;42(3):13–18).

15. Underwood S.R., Bax J.J., vom Dahl J. et al. Imaging techniques for the assessment of myocardial hibernation Report of a Study Group of the European Society of Cardiology. Eur Heart J 2004; 25(10):815-836

16. Marshall R.C., Tillisch J.H., Phelps M.E. et al. Identification and differentiation of resting myocardial ischemia and infarction in man with positron computed tomography, 18-F-labeled fluorodeoxyglucose and N-13 ammonia. Circulation 1983;67:766–788.

17. Tillisch J., Brunken R., Marshall R. et al. Reversibility of cardiac wall-motion abnormalities predicted by positron emission tomography. N Engl J Med 1986;314:884–888.

18. Bonow R.O. Identification of viable myocardium. Circulation 1996; 94:2674–2680.

19. Ragosta M., Beller G.A., Watson D.D. et al. Quantitative planar rest-redistribution Tl-201 imaging in detection of myocardial viability and prediction of improvement in left ventricular function after coronary bypass surgery in patients with severely depressed left ventricular function. Circulation 1993;87:1630–1641.

20. Pohost G.M., Alpert N.S., Ingwall J.S. et al. Thallium redistribution: mechanisms and clinical utility. Semin Nucl Med 1980;20:70–93.

21. Bailey I.K., Griffith L.S.E., Rouleau L. Tl–201 myocardial perfusion imaging at rest and during exercise. Comparison of sensitivity to ECG in coronary artery disease. Circulation 1977; 55:80–87.

22. Chernov V.I., Lishmanov Yu.B., Vesnina Zh.B. et al. Quantitative evaluation of myocardial perfusion scintigraphy with thallium-199 in patients with coronary artery disease. Meditsinskaya radiologiya i radiatsionnaya bezopasnost' 1999;44(3):46–50. Russian (Чернов В.И., Лишманов Ю.Б., Веснина Ж.Б. и соавт. Количественная оценка результатов перфузионной сцинтиграфии миокарда с таллием–199 у больных ИБС. Медицинская радиология и радиационная безопасность 1999;44(3):46–50).

23. Perrone–Filardi P., Pace L., Rastaro M. Assessment of myocardial viability in patients with chronic coronary artery disease: resting 4 hour – 24 hour 201 thallium tomography vs dobutamine echocardiography. Circulation 1996;94:2712–2719.

24. Kiser J.W. Prediction of myocardial viability: Tl–201 versus sestamibi versus teboroxime compared with FDG uptake. Clin Nucl Med 1998;23(7):432–436.

25. Le Feuvre C., Baubion N., Auby N. Assessment of reversible dyssynergic segments after acute myocardial infarction: dobutamine echocardiography vs Thallium – 201 single photon emission computed tomography. Am Heart J 1996;131:668–675.

26. Naruse H. Comparison of accuracy of various Tl–201 reinjection imaging protocols to detect myocardial viability. Ann Nucl Med 1996;10:119–126.

27. Scherrer–Crosbie M. Usefulness of redistribution images in viability detection after acute myocardial infarction. Am J Cardiol 1996;77:922–926.

28. Weintraub W.S., Hattori S., Aggarwal J.B. The relation between myocardial blood flow and contraction by myocardial layer in the canine left ventricle during ischemia. Circulation Res 1981; 48:430–438.

29. Lieberman A.N., Weiss J.L., Jugdutt B.I. Two–dimensional echocardiography and infarct size: relationship of regional wall motion and thinning to the extent of myocardial infarction. Circulation 1981;63:739–746.

30. Lualdi J.C., Douglas P.S. Echocardiography for the assessment of myocardial viability. J Am Soc Echocardiogr 1997;10(7):772–780.

31. Pierard L.A., Hoffer E.P. Role of stress echocardiography in heart failure. Am J Cardiol 1998;81(12):33G– 35G.

32. Aronov D.M., Lupanov V.P. Functional tests in cardiology. Kardiologiia1996; 36 (8) :94-102. Russian (Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. Кардиология 1996;36(8):94–102).

33. Belenkov Yu.N. Non-invasive diagnosis of coronary artery disease. Cardiology 1996; 36 (1) :4-12. Russian (Беленков Ю.Н. Неинвазивные методы диагностики ИБС. Kardiologiia 1996;36(1):4–12).

34. Armstrong W.F. Stress echocardiography: introduction, history and methods. Prog Cardiovasc Dis 1997;39(6):499–522.

35. Meyer L., Curry G., Donsky M. et al. Influence of dobutamine on hemodynamics and coronary blood flow in patients with and without coronary artery disease. Am J Cardiol 1976; 38:1–12.

36. McGillem M.J., De Boe S.F., Friedman H.Z. The effect of dopamine and dobutamine on regional function in presence of rigid coronary stenosis and subcritical impairment of reactive hyperaemia. Am Heart J 1988;115: 970–977.

37. Fung A.Y., Gallagher K.P., Buda A.J. The physiologic basis of dobutamine as compared with dipyridamole stress interventions in the assessment of critical coronary stenosis. Circulation 1987;76:943– 951.

38. Mertes H., Sawada S.G., Ryan T. et al. Symptoms, adverse effects and complications associated with dobutamine stress echocardiography. Experience in 1118 patients. Circulation 1993;88(1):15–19.

39. Secknus M., Marwick T. Evolution of dobutamine echocardiography protocols and indications: safety and side effects in 3011 studies over 5 years. J Am Coll Cardiol 1997;29: 1234–1240.

40. Beckmann S., Bocksch W., Muller C., Schartl M. Does dobutamine stress echocardiography induce damage during viability diagnosis of patients with chronic regional dysfunction after myocardial infarction? Schweiz Med Wochenschr 1997; 127(48):2008–2013.

41. Chauvel C., Cohen A., Khireddine M. Safety of dobutamine stress echocardiography: A 24 h Holter monitoring study. Eur Heart J 1996;17:1898-1901.

42. Salustri A., Elhendy A., Garyfallidis P. Prediction of improvement of ventricular function after first acute myocardial infarction using low dose dobutamine stress echocardiography. Am J Cardiol 1994;74:853– 856.

43. Castini D. Early assessment of viable myocardium after acute myocardial infarction by low–dose echo– dobutamine. G Ital Cardiol 1998;28(11):1215–1224.

44. Pagano D. Predictive value of dobutamine echocardiography and positron emission tomography in identifying hibernating myocardium in patients with postischaemic heart failure. Heart 1998;79(3):281– 218.

45. Poldermans D. Safety and utility of atropine addition during dobutamine stress echocardiography for the assessment of viable myocardium in patients with severe left ventricular dysfunction. Eur Heart J 1998;19(11):1712–1720.

46. Bonow R.O. Identification of viable myocardium. Circulation 1996;94:2674–2680.

47. Smart S.C., Sawada S., Ryan T. Low dose dobutamine stress echocardiography detects reversible dysfunction after trombolytic therapy of acute myocardial infarction. Circulation 1993;91:663–670.

48. Kaul S. There may be more to myocardial viability than meets the eye. Circulation 1995;92:2790– 2793.

49. Sabja P.J., Powers E.R., Ragosta M. An association between collateral blood flow and myocardial viability in patients with recent myocardial infarction. N Engl J Med 1992;372:1825–1831.

50. Main M.L., Grayburn P.A., Landau C. Relation of contractile reserve during low dose dobutamine stress echocardiography and angiographic extent and severity of coronary artery disease in the presence of left ventricle dysfunction. Am J Cardiol 1997;79:1309–1313.

51. Perrone-Filardi P., Pace L., Prastaro M. Assessment of Myocardial Viability in Patients With Chronic Coronary Artery Disease. Rest–4-Hour–24-Hour 201Tl Tomography Versus Dobutamine Echocardiography. Circulation 1996;94:2712-2719.

52. Panza J.A., Dilsizian V., Laurienzo J.M. et al. Relation between thallium uptake and contractile response to dobutamine: implications regarding myocardial viability in patients with chronic coronary artery disease and left ventricular dysfunction. Circulation 1995;91:990–998.

53. Maes A., Flameng W., Nuyts J. Histological alterations in chronically hypoperfused myocardium: correlation with positron emission tomography findings. Circulation 1994;90: 735–745.

54. Cornel J.H., Bax J.J., Elhendy A. et al. Agreement and disagreement between "metabolic viability" and "contractile reserve" in akinetic myocardium. J Nucl Cardiol 1999;6(4):383–388.

55. Baumgartner H., Porenta G., Lau Y.K. et all. Assessment of myocardial viability by dobutamine echocardiography, positron emission tomography and thallium-201 SPECT. Correlation with histopathology in explanted hearts. J Am Coll Cardiol 1998; 32:1701-1708.

56. Armstrong W.F. Stress echocardiography: introduction, history and methods. Prog Cardiovasc Dis 1997; 39(6):499–522.

57. Madler C., Payne N., Wilkenshoff U. Non-invasive diagnosis of coronary artery disease by quantitative stress echocardiography:optimal diagnostic models using off-line tissue Dopplerin the MYDISE study. Eur Heart J 2003;24:1587-94.

58. Cain P., Baglin T., Case C. et al. Application of tissue Doppler to interpretation of dobutamine echocardiography and comparison with quantitative coronary angiography. Am Coll Cardiol 2001;87:525-31.

59. Miyatake K., Yamagishi M., Tanaka N. et al. New method for evaluating left ventricular wall motion by color-coded tissue Doppler imaging: in vitro and in vivo studies. J Am Coll Cardiol 1995;25:717– 724.

60. Tsutsui H., Uematsu M., Shimizu H. et al. Comparative usefulness of myocardial velocity gradient in detecting ischemic myocardium by a dobutamine challenge. J Am Coll Cardiol 1998;31:89–93.

61. Dandel M., Lehmkuhl H., Knosalla C. et al. Strain and Strain Rate Imaging by Echocardiography – Basic Concepts and Clinical Applicability. Current Cardiology Reviews 2009; 5: 133-148.

62. Marwick T.H., Cheuk-Man Yu., Jing Ping Sun. Myocardial Imaging: Tissue Doppler and Speckle Tracking. Oxford: Blackwell Publishing; 2007.

63. D’Hooge J., Heimdal A., Jamal F. et al. Regional strain and strain rate measurements by cardiac ultrasound: principles, implementation and limitations. Eur J Echocardiogr 2000; 1(3): 154-70.

64. Yip G.W., Ommen S.R. Tissue doppler imaging in coronary artery disease. Heart views 2002; 3(1):

65. Voigt J.U., Exner B., Schmiedehausen K. et al. Strain-rate imaging during dobutamine stress echocardiography provides objective evidence of inducible ischemia. Circulation 2003;107:2120–6.

66. Hoffmann R., Altiok E., Nowak B. et al. Strain rate measurement by doppler echocardiography allows improved assessment of myocardial viability inpatients with depressed left ventricular function. J Am Coll Cardiol 2002;39;443-449.

67. 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: Follow-Up Study After Revascularization. Circulation 2005;112;3892-3900.

68. Picano E., Lattanzi F., Orlandini A. et al. Stress echocardiography and the human factor: the importance of being expert. J Am Coll Cardiol 1991;17:666–669.


For citations:

Perutskiy D.N., Makeeva T.I., Konstantinov S.L. VALUE OF STRESS ECHOCARDIOGRAPHY IN DIAGNOSIS OF VIABLE MYOCARDIUM IN PATIENTS WITH ISCHEMIC HEART DISEASE. Rational Pharmacotherapy in Cardiology. 2011;7(3):334-341. (In Russ.)

Views: 749

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)