University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT, 06030, USA,
J Nucl Cardiol. 2013 Dec;20(6):1173-83. doi: 10.1007/s12350-013-9776-1.
The incidence of heart failure (HF) is increasing and it remains the only area in cardiovascular disease wherein hospitalization rates and mortalities have worsened in the past 25 years. This review is provided to assess the role of radionuclide imaging in HF. The focus is on three aspects: the value of nuclear imaging to distinguish ischemic from non-ischemic etiologies; risk stratification of patients with HF with evaluation of candidates for specific treatment strategies; and the role of cardiac neuronal imaging in patients with HF. Distinguishing ischemic from non-ischemic cardiomyopathy is important because patients with ischemic cardiomyopathy can potentially have dramatic improvement with revascularization. Single photon emission computed tomography (SPECT) has excellent reported sensitivity and negative predictive value in the detection of coronary artery disease in HF patients. SPECT imaging is also useful in establishing treatment strategies in patients with HF, including those with new onset CHF. Cardiac neuronal imaging of mIBG is particularly helpful in risk stratification of patients with HF. The modality can be used to monitor the response to therapy as dysfunctional mIBG uptake may show improvement with pharmacological treatment.
心力衰竭（HF）的发病率正在增加，它仍然是心血管疾病中唯一一个在过去 25 年中住院率和死亡率恶化的领域。本文旨在评估放射性核素成像在 HF 中的作用。重点关注三个方面：核成像在鉴别缺血性和非缺血性病因中的价值；HF 患者的风险分层，评估特定治疗策略的候选者；以及心脏神经元成像在 HF 患者中的作用。区分缺血性和非缺血性心肌病很重要，因为缺血性心肌病患者通过血运重建可能会有明显改善。单光子发射计算机断层扫描（SPECT）在检测 HF 患者的冠状动脉疾病方面具有出色的报道敏感性和阴性预测值。SPECT 成像在 HF 患者的治疗策略中也很有用，包括新发 CHF 患者。心脏去甲肾上腺素能成像的 mIBG 对 HF 患者的风险分层特别有帮助。该方法可用于监测治疗反应，因为功能障碍的 mIBG 摄取可能会随着药物治疗而改善。
