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STATE-OF-THE-ART PAPER

Revascularization in Severe Left Ventricular Dysfunction

The Role of Viability Testing

Panithaya Chareonthaitawee, MD, FACC^_*,_*, Bernard J. Gersh, MB, ChB, DPhil, FACC^_*, Philip A. Araoz, MD and Raymond J. Gibbons, MD, FACC^_*

^_* Division of Cardiovascular Diseases
Department of Radiology, Mayo Clinic, Rochester, Minnesota

Manuscript received December 3, 2004; revised manuscript received March 9, 2005, accepted March 15, 2005.

^_* Reprint requests and correspondence: Dr. Panithaya Chareonthaitawee, Division of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905 (Email: chareonthaitawee.panithaya{at}mayo.edu).

Revascularization is a treatment option for moderate-to-severe ischemic cardiomyopathy. Limitations of the current literature, lack of completed randomized trials, and higher periprocedural risks create significant uncertainty about the optimal treatment strategy. This review focuses on the available literature describing the effect of revascularization on outcome and the role of noninvasive viability testing. It attempts to identify a subset of patients likely to benefit from therapy.

Abbreviations and Acronyms   ACC/AHA = American College of Cardiology/American Heart Association   CABG = coronary artery bypass grafting   CAD = coronary artery disease   FDG = F-18 fluorodeoxyglucose   HF = heart failure   LV = left ventricle/ventricular   LVEF = left ventricular ejection fraction   MRI = magnetic resonance imaging   PET = positron emission tomography   PTCA = percutaneous transluminal coronary angioplasty   SPECT = single-photon emission computed tomography

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