Congestive heart failure myocardial viability study: Difference between revisions

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{{Congestive heart failure}}
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==Overview==
==Overview==
Myocardial viability studies can determine whether hypocontractile myocardium is viable but just hibernating, and could therefore benefit from [[revascularization]].  
[[Single-photon emission CT ]] ([[SPECT]]) can also be used to assess [[myocardial ischemia]] and [[viability]], [[myocardial inflammation]] or [[infiltration]].
[[Scintigraphy]] with [[technetium]] ([[Tc]])-labeled bisphosphonate has shown high sensitivity and specificity for imaging [[cardiac transthyretin amyloid]].


==Myocardial Viability Studies==
==Myocardial Viability Studies==
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*[[Cardiovascular magnetic resonance imaging (CMR)|Cardiac MRI]]
*[[Cardiovascular magnetic resonance imaging (CMR)|Cardiac MRI]]


==2009 ACC/AHA Focused Update on Guidelines for the Diagnosis and Management of Chronic Heart Failure in the Adult- Recommendations for Myocardial Viability Studies in Patients Presenting With Heart Failure (DO NOT EDIT) <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref><ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>==
===2021 European Society of Cardiology Guidelines (DO NOT EDIT) <ref name="pmid34447992">{{cite journal |vauthors=McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland JGF, Coats AJS, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam CSP, Lyon AR, McMurray JJV, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano GMC, Ruschitzka F, Kathrine Skibelund A |title=2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure |journal=Eur Heart J |volume=42 |issue=36 |pages=3599–3726 |date=September 2021 |pmid=34447992 |doi=10.1093/eurheartj/ehab368 |url=}}</ref>===
{|class="wikitable"
 
{|class="wikitable" style="width:80%"
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| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ESC guidelines classification scheme#Classification of Recommendations|Class IIb]]


|-
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|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Noninvasive imaging to detect [[myocardial ischemia]] and viability is reasonable in patients presenting with [[heart failure]] who have known [[coronary artery disease]] and no [[angina]] unless the patient is not eligible for [[revascularization]] of any kind. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>Non-invasive stress imaging ([[CMR]], [[stress echocardiography]], [[SPECT]], [[PET]]) may be considered for the assessment of [[myocardial ischemia]] and viability in [[patients]] with [[CAD]] who are considered suitable for [[coronary revascularization]]. ''([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>. [[Exercise testing]] may be considered to detect reversible [[myocardial ischemia]] and investigate the cause of [[dyspnea]]''([[ESC guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}
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{|class="wikitable"
===2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) <ref name="pmid35363500">{{cite journal| author=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM | display-authors=etal| title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. | journal=Circulation | year= 2022 | volume= 145 | issue= 18 | pages= e876-e894 | pmid=35363500 | doi=10.1161/CIR.0000000000001062 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=35363500  }} </ref> ===
 
{|class="wikitable" style="width:80%"
|-
|-
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]


|-
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Noninvasive imaging may be considered to define the likelihood of [[coronary artery disease]] in patients with [[heart failure]] and [[left ventricular dysfunction]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''6.''' In [[patients]] with [[HF]], an evaluation for possible [[ischemic heart disease]] can be useful to identify the cause and guide [[management]]. <ref name="pmid16098295">{{cite journal| author=Elhendy A, Sozzi F, van Domburg RT, Bax JJ, Schinkel AF, Roelandt JR | display-authors=etal| title=Effect of myocardial ischemia during dobutamine stress echocardiography on cardiac mortality in patients with heart failure secondary to ischemic cardiomyopathy. | journal=Am J Cardiol | year= 2005 | volume= 96 | issue= 4 | pages= 469-73 | pmid=16098295 | doi=10.1016/j.amjcard.2005.04.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16098295  }} </ref><ref name="pmid15077089">{{cite journal| author=Miller WL, Hodge DO, Tointon SK, Rodeheffer RJ, Nelson SM, Gibbons RJ| title=Relationship of myocardial perfusion imaging findings to outcome of patients with heart failure and suspected ischemic heart disease. | journal=Am Heart J | year= 2004 | volume= 147 | issue= 4 | pages= 714-20 | pmid=15077089 | doi=10.1016/j.ahj.2003.10.045 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15077089  }} </ref><ref name="pmid32588042">{{cite journal| author=Chow BJW, Coyle D, Hossain A, Laine M, Hanninen H, Ukkonen H | display-authors=etal| title=Computed tomography coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE-HF 1C). | journal=Eur Heart J Cardiovasc Imaging | year= 2021 | volume= 22 | issue= 9 | pages= 1083-1090 | pmid=32588042 | doi=10.1093/ehjci/jeaa109 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32588042  }} </ref><ref name="pmid28798192">{{cite journal| author=Ferreira JP, Rossignol P, Demissei B, Sharma A, Girerd N, Anker SD | display-authors=etal| title=Coronary angiography in worsening heart failure: determinants, findings and prognostic implications. | journal=Heart | year= 2018 | volume= 104 | issue= 7 | pages= 606-613 | pmid=28798192 | doi=10.1136/heartjnl-2017-311750 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28798192  }} </ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence:B-NR]])'' <nowiki>"</nowiki>
 
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*[[Exercise stress testing#Techniques used to Assess Myocardial Viability|Techniques used to Assess Myocardial Viability]]
*[[Exercise stress testing#Techniques used to Assess Myocardial Viability|Techniques used to Assess Myocardial Viability]]


==Vote on and Suggest Revisions to the Current Guidelines==
==External Link==
*[[The Living Guidelines: Diagnosis and Management of Chronic Heart Failure | The CHF Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
*[https://www.ahajournals.org/doi/epub/10.1161/CIR.0000000000001063.full.pdf 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines]<ref name="pmid35363499">{{cite journal |vauthors=Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW |title=2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines |journal=Circulation |volume=145 |issue=18 |pages=e895–e1032 |date=May 2022 |pmid=35363499 |doi=10.1161/CIR.0000000000001063 |url=}} </ref>
 
==Guidelines Resources==
*[http://circ.ahajournals.org/content/112/12/e154.full.pdf The ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult] <ref name="Hunt"> Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B; American College of Cardiology; American Heart Association Task Force on Practice Guidelines; American College of Chest Physicians; International Society for Heart and Lung Transplantation; Heart Rhythm Society. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): developed in collaboration with the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: endorsed by the Heart Rhythm Society. Circulation. 2005 Sep 20; 112(12): e154-235. Epub 2005 Sep 13. PMID 16160202</ref>
 
*[http://content.onlinejacc.org/cgi/reprint/53/15/1343.pdf 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation] <ref name="pmid19324967">Jessup M, Abraham WT, Casey DE, Feldman AM, Francis GS, Ganiats TG et al. (2009) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19324967 2009 focused update: ACCF/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation.] ''Circulation'' 119 (14):1977-2016. [http://dx.doi.org/10.1161/CIRCULATIONAHA.109.192064 DOI:10.1161/CIRCULATIONAHA.109.192064] PMID: [http://pubmed.gov/19324967 19324967]</ref>


==References==
==References==
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Latest revision as of 20:48, 22 June 2022



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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Sara Zand, M.D.[2] Lakshmi Gopalakrishnan, M.B.B.S. [3]

Overview

Single-photon emission CT (SPECT) can also be used to assess myocardial ischemia and viability, myocardial inflammation or infiltration. Scintigraphy with technetium (Tc)-labeled bisphosphonate has shown high sensitivity and specificity for imaging cardiac transthyretin amyloid.

Myocardial Viability Studies

Common imaging modalities to assess myocardial viability include:

2021 European Society of Cardiology Guidelines (DO NOT EDIT) [1]

Class IIb
"Non-invasive stress imaging (CMR, stress echocardiography, SPECT, PET) may be considered for the assessment of myocardial ischemia and viability in patients with CAD who are considered suitable for coronary revascularization. (Level of Evidence: B) "
". Exercise testing may be considered to detect reversible myocardial ischemia and investigate the cause of dyspnea(Level of Evidence: C) "

2022 AHA/ACC/HFSA Heart Failure Guideline (DO NOT EDIT) [2]

Class IIa
"6. In patients with HF, an evaluation for possible ischemic heart disease can be useful to identify the cause and guide management. [3][4][5][6] (Level of Evidence:B-NR) "

Related Chapters

External Link

References

  1. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, Burri H, Butler J, Čelutkienė J, Chioncel O, Cleland J, Coats A, Crespo-Leiro MG, Farmakis D, Gilard M, Heymans S, Hoes AW, Jaarsma T, Jankowska EA, Lainscak M, Lam C, Lyon AR, McMurray J, Mebazaa A, Mindham R, Muneretto C, Francesco Piepoli M, Price S, Rosano G, Ruschitzka F, Kathrine Skibelund A (September 2021). "2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure". Eur Heart J. 42 (36): 3599–3726. doi:10.1093/eurheartj/ehab368. PMID 34447992 Check |pmid= value (help). Vancouver style error: initials (help)
  2. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM; et al. (2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e876–e894. doi:10.1161/CIR.0000000000001062. PMID 35363500 Check |pmid= value (help).
  3. Elhendy A, Sozzi F, van Domburg RT, Bax JJ, Schinkel AF, Roelandt JR; et al. (2005). "Effect of myocardial ischemia during dobutamine stress echocardiography on cardiac mortality in patients with heart failure secondary to ischemic cardiomyopathy". Am J Cardiol. 96 (4): 469–73. doi:10.1016/j.amjcard.2005.04.004. PMID 16098295.
  4. Miller WL, Hodge DO, Tointon SK, Rodeheffer RJ, Nelson SM, Gibbons RJ (2004). "Relationship of myocardial perfusion imaging findings to outcome of patients with heart failure and suspected ischemic heart disease". Am Heart J. 147 (4): 714–20. doi:10.1016/j.ahj.2003.10.045. PMID 15077089.
  5. Chow BJW, Coyle D, Hossain A, Laine M, Hanninen H, Ukkonen H; et al. (2021). "Computed tomography coronary angiography for patients with heart failure (CTA-HF): a randomized controlled trial (IMAGE-HF 1C)". Eur Heart J Cardiovasc Imaging. 22 (9): 1083–1090. doi:10.1093/ehjci/jeaa109. PMID 32588042 Check |pmid= value (help).
  6. Ferreira JP, Rossignol P, Demissei B, Sharma A, Girerd N, Anker SD; et al. (2018). "Coronary angiography in worsening heart failure: determinants, findings and prognostic implications". Heart. 104 (7): 606–613. doi:10.1136/heartjnl-2017-311750. PMID 28798192.
  7. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CW (May 2022). "2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines". Circulation. 145 (18): e895–e1032. doi:10.1161/CIR.0000000000001063. PMID 35363499 Check |pmid= value (help).

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