Ischaemic cardiomyopathy (ICM) represents an important cardiovascular condition associated with substantially increased morbidity and mortality. It is characterised from a broad spectrum of clinical manifestations and pathophysiological substrates and its diagnosis is based on the demonstration of significant left ventricular dysfunction in the context of significant epicardial coronary artery disease. Contemporary management aims at improving prognosis through evidence-based pharmacotherapy and device therapy, where indicated. Whilst the beneficial role of revascularisation remains clear in patients with strong indications such as those with symptoms and/or acute coronary syndromes, for those patients that are asymptomatic and suffer from stable ischaemic heart disease the impact of revascularisation on hard outcomes remains less well defined and currently its adoption is hampered by the lack of robust randomised data. The aim of this review is therefore to provide a constructive appraisal on the pathophysiology of ICM, the role of the various non-invasive imaging techniques in the diagnosis of ICM and the differentiation between viable and non-viable myocardium and finally discourse the potential role of revascularisation and contemporary device therapy in the management of patients with ICM.

中文翻译：

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缺血性心肌病。病理生理学见解，诊断管理以及血运重建和器械治疗的作用。先进技术时代的差距和困境。

缺血性心肌病（ICM）代表着一种重要的心血管疾病，其发病率和死亡率大大增加。它具有广泛的临床表现和病理生理学特征，其诊断是基于在重大心外膜冠状动脉疾病的情况下显示出明显的左心功能不全。当代管理旨在通过基于证据的药物疗法和器械疗法（如有指示）改善预后。虽然血运重建的有益作用在具有明显适应症的患者（例如具有症状和/或急性冠脉综合征的患者）中仍然很明显，对于那些无症状且患有稳定的缺血性心脏病的患者，血运重建对硬结局的影响仍然不太明确，目前由于缺乏可靠的随机数据而阻碍了其应用。因此，本综述的目的是对ICM的病理生理学，各种非侵入性成像技术在ICM诊断中的作用以及活与非活心肌的区别进行建设性评估，并最终探讨ICM的潜在作用。 ICM患者的血运重建和现代器械治疗。