Radionuclide imaging in ischaemic heart failure.
BACKGROUND
Many tests are available for the investigation of patients with heart failure. The identification of the underlying aetiology of ventricular dysfunction is crucial as early treatment may limit or even reverse myocardial abnormalities.


METHODS
This article describes cardiac radionuclide imaging techniques and their applications in ischaemic ventricular dysfunction. Evidence for the role of these techniques is summarized with particular reference to current guidelines.


RESULTS
Both positron emission tomography (PET) and single photon emission computed tomography (SPECT) techniques are widely validated for the detection of myocardial viability and their use is recommended in both national and international guidelines.


RESULTS
Although assessments of ventricular phase and myocardial innervation hold promise for the stratification of patients to cardiac resynchronization therapy, the poor performance of echocardiographic predictors of response in the recently published PROSPECT trial suggest that these techniques face a tough challenge.


CONCLUSIONS
The use of integrated multimodality imaging techniques such as PET/computed tomography to assess for ischaemic causes of left ventricular dysfunction is an area that is currently under investigation, as is the role of nuclear techniques in the assessment of stem cell retention, distribution and function when used in patients with heart failure.


CONCLUSIONS
Ongoing developments in radionuclide molecular imaging for assessment of angiogenesis, apoptosis and interstitial alterations during cardiac remodeling may have important implications for the prognosis and treatment of patients with heart failure.
Stirrup
James
J
Department of Nuclear Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Saint Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Maenhout
Annelies
A
Wechalekar
Kshama
K
Anagnostopoulos
Constantinos
C
D002304:Cardiac Pacing, Artificial; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology
D019275:Radiopharmaceuticals