Otto Lang, Milan Kamínek
Viable myocardium is defined as a dysfunctional myocardium that can restore its contractile function as its coronary supply become adequate. Its detection is an important issue in the work-up of patients with ischemic heart disease in the stage of cardiac failure in the era of revascularization surgery and interventional cardiology. Revascularization of such patients with viable myocardium decreased yearly mortality of 79.6 % (from 16 % to 3.2 %) comparing to conservative therapy; on the other hand, revascularization of patients without viable myocardium slightly increased yearly mortality (from 6.2 % to 7.7 %). Methods of nuclear cardiology use several different principles for myocardial viability assessment. Detection of residual perfusion and cell membrane integrity are the most available methods, detection of cell metabolism is the most sensitive one.