Taxonomy of segmental myocardial systolic dysfunction

Eur Heart J. 2017 Apr 1;38(13):942-954. doi: 10.1093/eurheartj/ehw140.

Abstract

The terms used to describe different states of myocardial health and disease are poorly defined. Imprecision and inconsistency in nomenclature can lead to difficulty in interpreting and applying trial outcomes to clinical practice. In particular, the terms 'viable' and 'hibernating' are commonly applied interchangeably and incorrectly to myocardium that exhibits chronic contractile dysfunction in patients with ischaemic heart disease. The range of inherent differences amongst imaging modalities used to define myocardial health and disease add further challenges to consistent definitions. The results of several large trials have led to renewed discussion about the classification of dysfunctional myocardial segments. This article aims to describe the diverse myocardial pathologies that may affect the myocardium in ischaemic heart disease and cardiomyopathy, and how they may be assessed with non-invasive imaging techniques in order to provide a taxonomy of myocardial dysfunction.

Keywords: Heart failure; Non-invasive imaging; Systolic dysfunction; Taxonomy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Cardiac Imaging Techniques / methods
  • Cardiomyopathy, Dilated / classification
  • Cardiomyopathy, Dilated / metabolism
  • Cardiomyopathy, Dilated / pathology*
  • Cardiomyopathy, Hypertrophic / classification
  • Cardiomyopathy, Hypertrophic / metabolism
  • Cardiomyopathy, Hypertrophic / pathology*
  • Chronic Disease
  • Heart / physiology
  • Heart Failure, Diastolic / classification
  • Heart Failure, Diastolic / metabolism
  • Heart Failure, Diastolic / pathology
  • Humans
  • Myocardial Infarction / classification
  • Myocardial Infarction / metabolism
  • Myocardial Infarction / pathology
  • Myocardial Ischemia / classification
  • Myocardial Ischemia / metabolism
  • Myocardial Ischemia / pathology*
  • Myocardial Stunning / classification
  • Myocardial Stunning / metabolism
  • Myocardial Stunning / pathology
  • Myocardium / pathology
  • Myocytes, Cardiac / metabolism
  • Myocytes, Cardiac / physiology
  • Terminology as Topic