Hibernating Myocardium Identified by Cardiovascular Magnetic Resonance and Positron Emission Tomography

A 72-year-old woman was admitted with chest pain. On ECG, abnormal Q wave was noted in leads II, III, aVF, V1, and V2. Coronary angiography revealed occluded right and left anterior descending coronary arteries. Collateral vessels were observed from the left circumflex coronary artery to the right coronary artery.Dynamic first-pass magnetic resonance (MR) perfusion imaging was performed in a resting condition, using 0.075 mmol/kg gadodiamide (Gd DTPA-BMA) and saturation-recovery gradient echo sequence. Fifteen minutes after a 0.15 mmol/kg dose of Gd DTPA-BMA was injected, delayed-enhanced MR images were acquired through the use of an inversion-recovery segmented gradient echo sequence. Additionally, cine MR images were acquired with the use of a segmented true fast imaging with steady-state precession sequence. Perfusion deficit was noted in the subendocardial layer of septal and inferior walls (Figure 1A and Figure 2A; Movie I and Movie II), …