Role of Cardiac MRI in Assessment of Myocardial Viability

Abstract

Coronary artery disease accounts for a major cause of left ventricular systolic dysfunction. Left ventricular systolic dysfunction is reversible with revascularization in cases of hibernation and stunned myocardium. Revascularization is dependent on not only the presence but also the extent of viability, and a viable myocardium is necessary for functional recovery. For the detection of viability, non-invasive imaging techniques depend on cell membrane integrity, preserved myocardial metabolism or the absence of scar tissue (gadolinium-enhanced magnetic resonance imaging) in areas of dysfunctional myocardium. The late enhancement allows for direct visualization of necrotic or scarred tissue. By measuring the transmural extent of late enhancement, the probability of mechanical improvement can precisely be given. Cardiac MR with LGE can predict recovery of left ventricular systolic function after revascularization.