Вальсальва

Actively contracting myocardium is considered viable ...

Именно этот key point мы все ждали от консенсусного документа.

И заключение, которое отлично описывает, как сейчас в мире обстоят дела с оценкой жизнеспособности миокарда:

Another important limitation is that myocardial viability has so far been considered as a binary phenomenon, rather than a continuum. Because of these limitations the current diagnosis of myocardial viability is not standardized. Three large randomized controlled trials assessing the survival benefit of revascularizing viable myocardium have provided neutral results, perhaps explained by methodological limitation including recruitment bias.