Department of Medicine, Yale Translational Research Imaging Center, Yale University School of Medicine, Section of Cardiovascular Medicine, New Haven, Connecticut, USA.
Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, Connecticut, USA.
Compr Physiol. 2019 Mar 14;9(2):477-533. doi: 10.1002/cphy.c180007.
Multimodality cardiovascular imaging is routinely used to assess cardiac function, structure, and physiological parameters to facilitate the diagnosis, characterization, and phenotyping of numerous cardiovascular diseases (CVD), as well as allows for risk stratification and guidance in medical therapy decision-making. Although useful, these imaging strategies are unable to assess the underlying cellular and molecular processes that modulate pathophysiological changes. Over the last decade, there have been great advancements in imaging instrumentation and technology that have been paralleled by breakthroughs in probe development and image analysis. These advancements have been merged with discoveries in cellular/molecular cardiovascular biology to burgeon the field of cardiovascular molecular imaging. Cardiovascular molecular imaging aims to noninvasively detect and characterize underlying disease processes to facilitate early diagnosis, improve prognostication, and guide targeted therapy across the continuum of CVD. The most-widely used approaches for preclinical and clinical molecular imaging include radiotracers that allow for high-sensitivity in vivo detection and quantification of molecular processes with single photon emission computed tomography and positron emission tomography. This review will describe multimodality molecular imaging instrumentation along with established and novel molecular imaging targets and probes. We will highlight how molecular imaging has provided valuable insights in determining the underlying fundamental biology of a wide variety of CVDs, including: myocardial infarction, cardiac arrhythmias, and nonischemic and ischemic heart failure with reduced and preserved ejection fraction. In addition, the potential of molecular imaging to assist in the characterization and risk stratification of systemic diseases, such as amyloidosis and sarcoidosis will be discussed. © 2019 American Physiological Society. Compr Physiol 9:477-533, 2019.
多模态心血管成像通常用于评估心脏功能、结构和生理参数，以促进众多心血管疾病（CVD）的诊断、特征描述和表型分析，以及进行风险分层和指导医学治疗决策。虽然这些成像策略很有用，但它们无法评估调节病理生理变化的潜在细胞和分子过程。在过去的十年中，成像仪器和技术取得了重大进展，同时探针开发和图像分析也取得了突破。这些进展与细胞/分子心血管生物学的发现相结合，促进了心血管分子成像领域的发展。心血管分子成像旨在非侵入性地检测和描述潜在的疾病过程，以促进早期诊断、改善预后，并在 CVD 的连续体中指导靶向治疗。临床前和临床分子成像最广泛使用的方法包括放射性示踪剂，这些示踪剂允许使用单光子发射计算机断层扫描和正电子发射断层扫描进行高灵敏度的体内分子过程检测和定量。本综述将描述多模态分子成像仪器，以及已建立的和新的分子成像靶点和探针。我们将重点介绍分子成像如何为确定各种 CVD 的潜在基础生物学提供有价值的见解，包括：心肌梗死、心律失常、非缺血性和缺血性心力衰竭伴射血分数降低和保留。此外，还将讨论分子成像在协助系统性疾病（如淀粉样变性和结节病）的特征描述和风险分层方面的潜力。© 2019 美国生理学会。《综合生理学》9:477-533, 2019.
