Assessing myocardial viability in coronary artery disease with magnetic resonance imaging

Magnetic resonance imaging (MRI) has emerged as an alternative test to assess the extent of myocardial injury in patients with ischemic heart disease. However, the relative value of the different MRI approaches remains undetermined. This study evaluated the relative contribution of MR first pass perfusion imaging, baseline and dobutamine cine MRI and delayed contrast-enhancement MRI for the assessment of myocardial viability in patients, considered potential candidates for revascularization. In 17 patients, the different MRI techniques were compared to each other and correlated to cardiac function after revascularization. Persistent segmental and global cardiac dysfunction at follow-up was most accurately predicted by the delayed contrast-enhanced MR images. Therefore delayed contrast-enhanced MRI evolves as a powerful technique, which can complement other non-invasive techniques in the assessment of viability.