Radionuclide techniques for the assessment of myocardial viability and hibernation

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Abstract
Currently, three routine courses of action are available: medical treatment, heart transplantation, and revascularisation. Newer therapeutic modalities include laser therapy, advanced surgery, assist devices, artificial hearts,3 and transplantation of different (progenitor) cells.4 These options should currently be considered experimental but may offer alternative treatments in the future. Medical treatment has improved substantially over the past years, with the introduction of angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, and spironolactone. Four recent trials have demonstrated the value of β adrenergic blocking agents in the treatment of patients with heart failure.5 Finally, amiodarone has been demonstrated to reduce sudden death in patients with heart failure.6 Despite all of these new drugs, mortality of patients with severe heart failure remains high; Cowie and colleagues7 reported 12 month mortality to be 38% and extrapolation of these results demonstrated five year mortality to be > 70%.

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