Full Description
Myocardial viability has become one of the most important issues in clinical cardiology. In particular, absence or presence of viability may be decisive in patient management, and the decision to perform angioplasty (PTCA) or bypass surgery (CABG) is frequently based on the accurate assessment of viability. Although echocardiography and conventional nuclear medicine techniques may provide valuable information on viability, positron emission tomography (PET) is currently considered to be the gold standard for the assessment of myocardial viability. The simultaneous evaluation of myocardial metabolism and perfusion allows precise delineation and accurate quantification of residual myocardial viability in affected regions. In addition, accurate quantification of myocardial perfusion alone may provide insight into the basic mechanisms of syndrome X and may assist in the appropriate clarification of this clinically complicated, but frequently occurring phenomenon.
Besides that, cardiac PET may deepen our insight into metabolism and perfusion of cardiac muscle disease, particularly in hypertrophic cardiomyopathy. Furthermore, receptor imaging studies with PET will become important as the study of cardiac neurohumoral regulation in heart failure has gained in interest.
Cardiac Positron Emission Tomography: Viability, Perfusion, Receptors and Cardiomyopathy describes the most recent developments in cardiac PET as these are related to myocardial viability and myocardial perfusion studies of syndrome X. The value of PET for receptor imaging and cardiac muscle disease is also discussed.
For cardiologists, nuclear medicine physicians, radiochemists, physiologists, technicians and basic researchers interested in understanding the most recent achievements in cardiovascular PET.
Contents
State of the Art in Cardiac Positron Emission Tomography Wenckebach Lecture.- One: Myocardial viability.- 1. Myocardial viability: stunning and hibernation.- 2. Positron emission tomography assessment of myocardial viability.- 3. Comparison of thallium scintigraphy and positron emission tomography.- 4. Cardiac metabolism: positron emission tomography versus single photon emission computed tomography.- 5. The role of fluorine-18-deoxyglucose single photon emission computed tomography in predicting reversibility of regional wall motion abnormalities after revascularization.- 6. Parametric positron emission tomography imaging of myocardial perfusion and metabolism.- 7. Positron emission tomography compared to single photon emission computed tomography in the evaluation of myocardial viability: a preliminary cost-effectiveness analysis.- 8. Assessment of myocardial viability by pharmacological stress echocardiography.- 9. Assessment of myocardial viability by magnetic resonance imaging techniques.- Two: Hypertrophic cardiomyopathy.- 10. Classification of hypertrophic cardiomyopathy with magnetic resonance imaging compared with echocardiography.- 11. Positron emission tomography characterization of the myocardium in hypertrophie cardiomyopathy.- 12. Treatment of hypertrophie obstructive cardiomyopathy with pacing.- Three: Receptor imaging studies.- 13. Heart failure and the cardiac beta-adrenoceptor.- 14. Study of cardiac receptor ligands by positron emission tomography.- 15. Assessment of sympathetic cardiac innervation by scintigraphic techniques.- 16. Experimental and clinical cardiac beta-receptor studies.- Four: Myocardial Perfusion.- 17. Methodological issues in regional myocardial perfusion imaging with positron emission tomography.- 18. Altered autonomic control of the cardiovascular system in syndrome X.- 19. Positron emission tomography studies of cardiac neurostimulation.- Colour Section.
