Anales de la RANM

71 A N A L E S R A N M R E V I S T A F U N D A D A E N 1 8 7 9 HIBERNACIÓN Y DISINCRONÍA VENTRICULAR POSTINTERVENCIONISMO Federico Ferrando-Castagnetto An RANM · Año 2020 · número 137 (01) · páginas 65 a 72 de infarto, reducir la isquemia y reclutar miocardio viable. Una intervención percutánea primaria sobre las lesiones no culpables y un inicio más precoz de la terapia antiisquémica, por ejemplo, podrían ser estrategias a considerar. En segundo lugar, las medidas de DMVI obtenidas por diferentes técnicas podrían ser nuevos marcadores pronósticos no invasivos tras un evento coronario agudo. Finalmente, nuestros hallazgos sugieren que el umbral óptimo de captación utilizado para cuantificar el miocardio viable mediante gated-SPECT debería ser reconsiderado. En la enfermedad coronaria residual postintervencio- nismo existe una estrecha correlación entre la cuantía del miocardio hibernado y los índices de disincronía obtenidos por AF. La mejor correlación se observa al utilizar un umbral de captación miocárdica basal de 40%, especialmente cuando existe tejido cicatrizal asociado al miocardio hibernado. Una evaluacion individualizada y multimodal de la DMVI asociada al miocardio viable podria ahondar el conocimiento sobre la dinámica contráctil asociada a diferentes estados metabólicos miocárdicos y, quizás, aportar a la difícil toma de decisiones clínicas en la coronario- patía crónica. 1. Torrent-Guasp F. Structure and function of the heart. Rev Esp Cardiol 1998;51:91-102. 2. Helm P, Beg MF, Miller MI, et al. Measuring and mapping cardiac fiber and laminar architecture using diffusion tensor MR imaging. Ann NY Acad Sci 2005;1047:296-307. 3. Bogaert J, Rademakers FE. Regional nonunifor- mity of normal adult human left ventricle. Am J Physiol Heart Circ Physiol 2001;280:H610-20. 4. Abraham WT, Fisher WG, Smith AL, et al; MI- RACLE Study Group. Cardiac resynchroni- zation in chronic heart failure. 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