Hibernating Myocardium: Diagnosis and Patient Outcomes Arend F.L. Schinkel, MD, Jeroen J. Bax, MD, Don Poldermans, MD, Abdou Elhendy, MD, Roberto Ferrari, MD, and Shahbudin H. Rahimtoola, MD Abstract: Approximately 50% of the patients with chronic obstructive coronary artery disease resulting in chronic contractile dysfunction have hibernating myocardium and may benefit from revascularization. This pooled analysis describes the relative merits of dobutamine echocardiography, thallium-201 and tech- netium-99m scintigraphy, positron emission tomogra- phy, and magentic resonance imaging, for the diagnosis of hibernating myocardium and prediction of patient outcomes. (Curr Probl Cardiol 2007;32:375-410.) A ssessment of hibernating, viable myocardium is important in the evaluation and management of patients with ischemic left ventric- ular (LV) dysfunction. Patients with viable myocardium may improve in function after revascularization, whereas patients without viable myocardium do not improve in function. Various noninvasive imaging techniques are available for assessment of viable myocardium, and their relative merits for prediction of improvement in regional LV function after revascularization have been reported in 2001 in a pooled analysis of the available literature studies. 1 The current report is an update of this pooled analysis with inclusion of all published studies between 2001 and 2007. However, improvement of regional function is a very important but not the ideal endpoint after revascularization. Accordingly, the value of noninvasive assessment of viability and additional endpoints, including Curr Probl Cardiol 2007;32:375-410. 0146-2806/$ – see front matter doi:10.1016/j.cpcardiol.2007.04.001 Curr Probl Cardiol, July 2007 375