Demirkol Mehmet Onur
Department of Nuclear Medicine and Molecular Imaging, V.K.V. American Hospital, Istanbul, Turkey.
Anadolu Kardiyol Derg. 2008 Nov;8 Suppl 2:60-70.
In this article, the role of nuclear medicine modalities in assessing myocardial viability and risk stratification in patients with advanced left ventricular (LV) dysfunction are reviewed. Diagnosis of reversible LV dysfunction in patients with heart failure is an important clinical issue. Patients with severe LV dysfunction who have viable myocardium are the patients at highest risk because of the potential for ischemia but at the same time benefit most form revascularization. It is important to identify viable myocardium in these patients, and nuclear medicine techniques are an excellent tool for this. Single-photon emission computed tomography (SPECT) in combination with myocardial perfusion tracers plays an important role in the identification of tissue viability in myocardial segments. Imaging with positron emission tomography (PET) tracers allow the assessment of physiologic processes such as myocardial oxygen consumption, metabolic rate of glucose utilization, and myocardial blood flow. Metabolic imaging with PET offers regional tissue viability in patients with advanced coronary artery disease and severely impaired LV function.
本文综述了核医学方法在评估晚期左心室（LV）功能不全患者心肌存活能力及风险分层中的作用。心力衰竭患者可逆性LV功能不全的诊断是一个重要的临床问题。存在存活心肌的严重LV功能不全患者是风险最高的患者，因为有缺血的可能性，但同时从血运重建中获益最大。识别这些患者中的存活心肌很重要，而核医学技术是实现这一目标的优秀工具。单光子发射计算机断层扫描（SPECT）结合心肌灌注示踪剂在识别心肌节段的组织存活能力方面发挥着重要作用。使用正电子发射断层扫描（PET）示踪剂进行成像可评估诸如心肌氧消耗、葡萄糖利用代谢率和心肌血流等生理过程。PET代谢成像为晚期冠状动脉疾病和严重LV功能受损患者提供了局部组织存活能力的信息。
