Cardiovascular MRI: The Future is Now - Washington Hospital Center

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Noninvasive assessment of viability 1. Quantitative SPECT • > 50 % uptake of tracer ( 201 Tl, sestamibi, tetrofosmin) 2. PET imaging • m<strong>is</strong>match between flow and metabol<strong>is</strong>m (FDG) 3. FDG SPECT 4. Low dose dobutamine echocardiography • inotropic reserve 5. Contrast echocardiography • integrity of microcirculation 6. CMR • inotropic reserve; late gadolinium enhancement
Viability testing and outcomes Annual Cardiac Death Rate (%) 20 16 12 8 4 0 3.2 -80% p
Page 1: Assessment of Viability with CMR: W
Page 5 and 6: STICH Trial Velasquez EJ et al, NEJ
Page 7 and 8: Limitations of STICH Crossover in 1
Page 9 and 10: Infarct detection/transmurality Tec
Page 11 and 12: Size of HE Choi et al Circulation 2
Page 13 and 14: Reproducibility 48 pts., 3 centers
Page 15 and 16: SPECT vs. CMR 78 pts. acute MI at d
Page 17 and 18: LGE and prognosis Kwong, RY et al.
Page 19 and 20: Regional function %S 30 25 20 15 10
Page 21 and 22: Time to reperfusion Tarantini G et
Page 23 and 24: AMI - T2-W edema imaging - area at
Page 25 and 26: T2-W - edema/area at risk
Page 27 and 28: Hibernation - Late gadolinium enhan
Page 29 and 30: LGE vs. PET 31 pts., ischemic LV dy
Page 31 and 32: Viability - Late gadolinium enhance
Page 33 and 34: Viability - dobutamine tagged MRI 1
Page 35 and 36: Example images - nonviable segment
Page 37 and 38: Contrast vs. dobutamine All segment
Page 39: Conclusions If viability is of inte

Cardiovascular MRI: The Future is Now - Washington Hospital Center

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