Cardiac Positron Emission Tomography : Viability, Perfusion, Receptors and Cardiomyopathy

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. Front Matter....Pages i-xvi State of the Art in Cardiac Positron Emission Tomography Wenckebach Lecture ....Pages 1-14 Myocardial Viability: Stunning and Hibernation....Pages 15-24 Positron Emission Tomography Assessment of Myocardial Viability....Pages 25-35 Comparison of Thallium Scintigraphy and Positron Emission Tomography....Pages 37-50 Cardiac Metabolism: Positron Emission Tomography Versus Single Photon Emission Computed Tomography....Pages 51-73 The Role of Fluorine-18-Deoxyglucose Single Photon Emission Computed Tomography in Predicting Reversibility of Regional Wall Motion Abnormalities after Revascularization....Pages 75-85 Parametric Positron Emission Tomography Imaging of Myocardial Perfusion and Metabolism....Pages 87-96 Positron Emission Tomography Compared to Single Photon Emission Computed Tomography in the Evaluation of Myocardial Viability: A Preliminary Cost-Effectiveness Analysis....Pages 97-102 Assessment of Myocardial Viability by Pharmacological Stress Echocardiography....Pages 103-115 Assessment of Myocardial Viability by Magnetic Resonance Imaging Techniques....Pages 117-128 Classification of Hypertrophic Cardiomyopathy with Magnetic Resonance Imaging Compared with Echocardiography....Pages 129-135 Positron Emission Tomography Characterization of the Myocardium in Hypertrophic Cardiomyopathy....Pages 137-148 Treatment of Hypertrophic Obstructive Cardiomyopathy with Pacing....Pages 149-155 Heart Failure and the Cardiac Beta-Adrenoceptor....Pages 157-169 Study of Cardiac Receptor Ligands by Positron Emission Tomography....Pages 171-182 Assessment of Sympathetic Cardiac Innervation by Scintigraphic Techniques....Pages 183-199 Experimental and Clinical Cardiac Beta-receptor Studies....Pages 201-210 Methodological Issues in Regional Myocardial Perfusion Imaging with Positron Emission Tomography....Pages 211-220 Altered Autonomic Control of the Cardiovascular System in Syndrome X....Pages 221-230 Positron Emission Tomography Studies of Cardiac Neurostimulation....Pages 231-240 Back Matter....Pages 241-256 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.