title: New insights from major prospective cohort studies with cardiac nuclear imaging.
abstract: For more than two decades, radionuclide imaging has prevailed as a cornerstone in the diagnosis and treatment of patients with cardiac disease. From this experience, large cohort studies have emerged that demonstrate the prognostic value of cardiac radionuclide imaging in a variety of patient groups and conditions. Myocardial perfusion imaging has accrued the most robust evidence for accurate and independent risk stratification over traditional clinical variables. In a variety of patient populations, the presence of myocardial ischemia is a strong predictor of cardiac events on follow-up. In patients with heart failure, smaller observations have similarly established the prognostic value of viability imaging and imaging of cardiac sympathetic activity. The present review provides a summary of recent cohort studies with radionuclide imaging and a critical appraisal of their clinical implications. Its purpose is to put the available evidence into a clinical context, analyze its potential impact on patient management and identify gaps in knowledge and unanswered questions to be addressed in future randomized trials.
authors.affiliation: Cardiac Imaging and Interventional Cardiology, University Hospital Zurich, Zurich, Switzerland, oliver.gaemperli@usz.ch.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
mesh_terms: D003287:Contrast Media; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019786:Gadolinium DTPA; D006333:Heart Failure / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000473:pathology; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA