SPECT and PET in ischemic heart failure.
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.
Department of Nuclear Medicine, Larissa University Hospital, Larissa, Greece.
George
G
Angelidis
Department of Cardiology, Larissa University Hospital, P.O. Box 1425, 411 10, Larissa, Greece. ggiamou@emory.edu.
Gregory
G
Giamouzis
Department of Transplantation and Mechanical Circulatory Support, Harefield Hospital, London, UK.
Georgios
G
Karagiannis
Division of Cardiology, Stony Brook University, Stony Brook, New York, USA.
Javed
J
Butler
Department of Nuclear Medicine, Larissa University Hospital, Larissa, Greece.
Ioannis
I
Tsougos
Department of Nuclear Medicine, Larissa University Hospital, Larissa, Greece.
Varvara
V
Valotassiou
Department of Cardiology, AHEPA University Hospital, Thessaloniki, Greece.
George
G
Giannakoulas
Department of Nuclear Medicine, NIMTS Hospital, Athens, Greece.
Nikolaos
N
Dimakopoulos
Department of Cardiology, Larissa University Hospital, P.O. Box 1425, 411 10, Larissa, Greece.
Andrew
A
Xanthopoulos
Department of Cardiology, Larissa University Hospital, P.O. Box 1425, 411 10, Larissa, Greece.
John
J
Skoularigis
Department of Cardiology, Larissa University Hospital, P.O. Box 1425, 411 10, Larissa, Greece.
Filippos
F
Triposkiadis
Department of Nuclear Medicine, Larissa University Hospital, Larissa, Greece.
Panagiotis
P
Georgoulias
D018450:Disease Progression; D014943:Global Health; D006321:Heart / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D009017:Morbidity / Q000639:trends; D017202:Myocardial Ischemia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
18-fluoro-deoxyglucose; Heart failure; Ischemic; PET; Positron emission tomography; Rubidium-82; SPECT; Single photon emission computed tomography; Technetium-99 m; Thallium-201; Viability