Ischemic cardiomyopathy - severe contractile dysfunction and dilatation of the heart based on obstructive coronary arteries lesion. The success of surgical treatment of ischemic cardiomyopathy among other factors depends on the volume of dysfunctional but viable myocardium that can restore its contractile function after surgery: if the amount is insignificant, the risk from surgery exceeds that from medical therapy. The most accessible radionuclide method for identifying viable myocardium is myocardial perfusion scintigraphy with 201 Tl-based or 99m Tc-based radiopharmaceutical.

The review presents information on the potential application of these methods for predicting myocardial function recovery in left ventricle after the surgical treatment of patients with ischemic cardiomyopathy. The information about the diagnostic effectiveness of such scintigraphic symptoms as segmental accumulation of radiopharmaceutical, wall motion and systolic thickening analysis, eccentricity indices and mechanical dyssynchrony is given, as well as research data on myocardial perfusion scintigraphy in combination with vasodilator and inotropic agents such as dobutamine and nitroglycerin. In the final part of the review large-scale studies on the association of the presence of a viable myocardium and the prognosis of adverse cardiac events are analyzed.