Modern nuclear cardiac imaging in diagnosis and clinical management of patients with left ventricular dysfunction

Aiden Abidov, R. Hachamovitch, D. S. Berman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Congestive heart failure (CHF) has become a large social burden in modern Western society, with very high morbidity and mortality and extremely large financial costs. The largest cause of CHF is coronary heart disease, with ventricular dysfunction that may or may not be reversible by revascularization. Thus, evaluation of the viable myocardial tissue in patients with ischemic left ventricular (LV) dysfunction has important clinical and therapeutic implications. Furthermore, since patients with ventricular dysfunction are at higher operative risk, cardiologists and cardiac surgeons are commonly faced with issues regarding the balance between the potential risk vs benefit of revascularization procedures. Cardiac nuclear imaging [myocardial perfusion SPECT (MPS) and positron emission tomography (PET)] provide objective information that augments standard clinical and angiographic assessments of patients with ventricular dysfunction with respect to diagnosis (etiology), prognosis, and potential benefit from intervention. Development of the technology and methodology of gated MPS, now the routine method for MPS, allows assessment of the extent and severity of inducible ischemia as well as hypoperfused but viable myocardium, and also provides measurements of LV ejection fraction, regional wall motion, LV volume measurements, diastolic function and LV geometry. With PET, myocardial metabolism and blood flow reserve can be added to the measurements provided by nuclear cardiology procedures. This paper provides insight into the current evidence regarding settings in which nuclear cardiac imaging procedures are helpful in assessment of patients in the setting of coronary artery disease with severe LV dysfunction. A risk-benefit approach to MPS results is proposed, with principal focus on identifying patients at risk for major cardiac events who may benefit from myocardial revascularization.

Original languageEnglish (US)
Pages (from-to)505-519
Number of pages15
JournalMinerva Cardioangiologica
Volume52
Issue number6
StatePublished - Dec 2004
Externally publishedYes

Fingerprint

Left Ventricular Dysfunction
Single-Photon Emission-Computed Tomography
Ventricular Dysfunction
Perfusion
Positron-Emission Tomography
Heart Failure
Myocardial Revascularization
Myocardial Perfusion Imaging
Cardiology
Left Ventricular Function
Stroke Volume
Coronary Disease
Coronary Artery Disease
Myocardium
Ischemia
Technology
Morbidity
Costs and Cost Analysis
Mortality

Keywords

  • Coronary disease
  • Ischemic cardiomyopathy
  • Myocardial perfusion
  • Myocardial revascularization
  • Nuclear cardiology
  • Prognosis
  • Tomography, emission computed
  • Tomography, emission computed single photon
  • Ventricular dysfunction, left, diagnosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Modern nuclear cardiac imaging in diagnosis and clinical management of patients with left ventricular dysfunction. / Abidov, Aiden; Hachamovitch, R.; Berman, D. S.

In: Minerva Cardioangiologica, Vol. 52, No. 6, 12.2004, p. 505-519.

Research output: Contribution to journalArticle

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