Relationship Between Preoperative Viability and Postoperative Improvement in LVEF and Heart Failure Symptoms

The presence of myocardial viability is predictive of improvement in regional left ventricular (LV) function after revascularization. Studies on predicting improvement in global LV function are scarce, and the amount of viable myocardium needed for improve-ment in LV ejection fraction (LVEF) after revascularization is un-known. Moreover, whether the presence of viability is associated with relief of heart failure symptoms after revascularization is un-certain. Hence, the aims were to define the extent of viable myo-cardium needed for improvement in LVEF and to determine whether preoperative viability testing can predict improvement in heart failure symptoms. Methods: Patients (n 5 47) with ischemic cardiomyopathy (mean LVEF 6 SD, 30 % 6 6%) undergoing sur-gical revascularization were studied with 18F-FDG SPECT to as-sess viability. Regional and global function were measured before and 3–6 mo after revascularization. Heart failure symptoms wer