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Percutaneous Intervention for Concurrent Chronic Total Occlusions in Patients With STEMI: The EXPLORE Trial From Early Pharmacology to Recent Pharmacology Interventions in Acute Coronary Syndromes Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Appropriate Use Criteria and Health Status Outcomes Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN-CTO Registry Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography Selection of stenting approach for coronary bifurcation lesions A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure Percutaneous coronary intervention for coronary bifurcation disease: 11th consensus document from the European Bifurcation Club Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction

Review Article2017 Mar;22(2):243-261.

JOURNAL:Heart Fail Rev. Article Link

SPECT and PET in ischemic heart failure

Angelidis G, Giamouzis G, Karagiannis G et al. Keywords: 18-fluoro-deoxyglucose; Heart failure; Ischemic; PET; Positron emission tomography; Rubidium-82; SPECT; Single photon emission computed tomography; Technetium-99 m; Thallium-201; Viability

ABSTRACT


Heart failure is a common clinical syndrome associated with significant morbidity and mortality worldwide. Ischemic heart disease is the leading cause of heart failure, at least in the industrialized countries. Proper diagnosis of the syndrome and management of patients with heart failure require anatomical and functional information obtained through various imaging modalities. Nuclear cardiology techniques play a main role in the evaluation of heart failure. Myocardial single photon emission computed tomography (SPECT) with thallium-201 or technetium-99 m labelled tracers offer valuable data regarding ventricular function, myocardial perfusion, viability, and intraventricular synchronism. Moreover, positron emission tomography (PET) permits accurate evaluation of myocardial perfusion, metabolism, and viability, providing high-quality images and the ability of quantitative analysis. As these imaging techniques assess different parameters of cardiac structure and function, variations of sensitivity and specificity have been reported among them. In addition, the role of SPECT and PET guided therapy remains controversial. In this comprehensive review, we address these controversies and report the advances in patient's investigation with SPECT and PET in ischemic heart failure. Furthermore, we present the innovations in technology that are expected to strengthen the role of nuclear cardiology modalities in the investigation of heart failure.