Title: Reversible left ventricular dysfunction in patients with chronic coronary artery disease
- Wojciech Kosmala
- Editorial article
- Polish Journal of Cardiology
- Start page:
- Final page:
- coronary artery disease, reversible myocardial dysfunction
Coronary artery disease is a common cause of left ventricular dysfunction, which can be partially or com-pletely reversible afterthe restoration of myocardial perfusion. Two processes leading to reversible leftven-tricular dysfunction (RLVD) can be identified: repeating or chronić myocardial stunning as a result of recur-rent ischemia or intrinsic spontaneous decrease in cardiomyocyte metabolism and contractility in order to survive in conditions of diminished myocardial perfusion, which is called hibernation. Several techniques are used for the identification of RLVD: positron emission tomography (PET), low-dose dobutamine echo-cardiography (LDDE), myocardial contrast echocardiography, rest redistribution and exercise redistribution-reinjection thallium imaging, technetium 99m sestamibi SPECT, magnetic resonance imaging (MRI). All these techniques have high sensitivity (83-90%), whereas their specificity variesfrom 47-54% for thallium imaging, 69% for technetium sestaMIBI, 73% for PET to 81 % for LDDE. LDDE has special advantage for discrimina-tion of RLVD as the only method detecting the contractile reserve in dysfunctional segments.