Department of Nuclear Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Saint Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK.
Br Med Bull. 2009;92:43-59. doi: 10.1093/bmb/ldp029.
Many tests are available for the investigation of patients with heart failure. The identification of the underlying aetiology of ventricular dysfunction is crucial as early treatment may limit or even reverse myocardial abnormalities.
This article describes cardiac radionuclide imaging techniques and their applications in ischaemic ventricular dysfunction. Evidence for the role of these techniques is summarized with particular reference to current guidelines.
Both positron emission tomography (PET) and single photon emission computed tomography (SPECT) techniques are widely validated for the detection of myocardial viability and their use is recommended in both national and international guidelines.
Although assessments of ventricular phase and myocardial innervation hold promise for the stratification of patients to cardiac resynchronization therapy, the poor performance of echocardiographic predictors of response in the recently published PROSPECT trial suggest that these techniques face a tough challenge.
The use of integrated multimodality imaging techniques such as PET/computed tomography to assess for ischaemic causes of left ventricular dysfunction is an area that is currently under investigation, as is the role of nuclear techniques in the assessment of stem cell retention, distribution and function when used in patients with heart failure.
Ongoing developments in radionuclide molecular imaging for assessment of angiogenesis, apoptosis and interstitial alterations during cardiac remodeling may have important implications for the prognosis and treatment of patients with heart failure.
有许多测试可用于心力衰竭患者的检查。确定心室功能障碍的潜在病因至关重要，因为早期治疗可能会限制甚至逆转心肌异常。
本文描述了心脏放射性核素成像技术及其在缺血性心室功能障碍中的应用。总结了这些技术的作用证据，并特别参考了当前的指南。
正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）技术都广泛用于检测心肌活力，其使用在国家和国际指南中都得到了推荐。
尽管心室相位和心肌神经支配的评估有望对心脏再同步治疗的患者进行分层，但最近发表的 PROSPECT 试验中超声心动图预测反应的表现不佳表明，这些技术面临着严峻的挑战。
使用集成的多模态成像技术，如 PET/计算机断层扫描，评估左心室功能障碍的缺血原因，是目前正在研究的一个领域，核技术在评估心力衰竭患者干细胞保留、分布和功能方面的作用也是如此。
放射性核素分子成像在评估心脏重构期间血管生成、细胞凋亡和间质改变方面的不断发展可能对心力衰竭患者的预后和治疗有重要影响。
