Heart failure

ESC CardioMed ◽  
2018 ◽  
pp. 600-603
Author(s):  
Danilo Neglia ◽  
Oliver Gaemperli
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Radionuclide Imaging ◽  
Single Photon ◽  
Photon Emission ◽  
Treatment Strategies ◽  
Radionuclide Ventriculography ◽  
Myocardial Perfusion Spect ◽  
Emission Tomography ◽  
Positron Emission

Heart failure (HF) has turned into an increasing global socioeconomic issue associated with a high morbidity and mortality. Cardiac radionuclide imaging offers important clinical information for risk stratification and tailored treatment strategies in patients with HF. Ischaemic cardiomyopathy is the most common cause of HF. Left and right ventricular function can be assessed and quantified with radionuclide ventriculography (RNV) or gated scintigraphic studies. Additionally, radionuclide imaging may help to assess functional and metabolic integrity of dysfunctional myocardium. Chronic myocardial ischaemia can lead to variable reversible states of contractile impairment termed myocardial stunning or hibernation. Radionuclide techniques including positron emission tomography with 18F-fluorodeoxyglucose or myocardial perfusion scintigraphy can identify viable myocardium with the potential for functional recovery, and thereby guide revascularization procedures. Increased sympathetic myocardial innervation assessed by 131I-metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPECT) is associated with poorer HF outcomes and higher rates of sudden cardiac death or arrhythmia. Finally, left ventricular mechanical dyssynchrony can be evaluated using Fourier-transformed phase analysis of RNV or gated myocardial perfusion SPECT. This approach could potentially be useful to guide targeted resynchronization therapy in the future.

Nuclear cardiology: state of the art

Heart ◽  
2021 ◽  
pp. heartjnl-2019-315628
Author(s):  
Rebecca Schofield ◽  
Leon Menezes ◽  
Stephen Richard Underwood
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Radionuclide Imaging ◽  
Single Photon ◽  
Imaging Techniques ◽  
Sympathetic Innervation ◽  
Photon Emission ◽  
Myocardial Inflammation ◽  
Emission Computed Tomography ◽  
Device Infection

Radionuclide imaging remains an essential component of modern cardiology. There is overlap with the information from other imaging techniques, but no technique is static and new developments have expanded its role. This review focuses on ischaemic heart disease, heart failure, infection and inflammation. Radiopharmaceutical development includes the wider availability of positron emission tomography (PET) tracers such as rubidium-82, which allows myocardial perfusion to be quantified in absolute terms. Compared with alternative techniques, myocardial perfusion scintigraphy PET and single photon emission computed tomography (SPECT) have the advantages of being widely applicable using exercise or pharmacological stress, full coverage of the myocardium and a measure of ischaemic burden, which helps to triage patients between medical therapy and revascularisation. Disadvantages include the availability of expertise in some cardiac centres and the lack of simple SPECT quantification, meaning that global abnormalities can be underestimated. In patients with heart failure, despite the findings of the STICH (Surgical Treatment for Ischemic Heart Failure) trial, there are still data to support the assessment of myocardial hibernation in predicting when abolition of ischaemia might lead to improvement in ventricular function. Imaging of sympathetic innervation is well validated, but simpler markers of prognosis mean that it has not been widely adopted. There are insufficient data to support its use in predicting the need for implanted devices, but non-randomised studies are promising. Other areas where radionuclide imaging is uniquely valuable are detection and monitoring of endocarditis, device infection, myocardial inflammation in sarcoidosis, myocarditis and so on, and reliable detection of deposition in suspected transthyretin-related amyloidosis.

scholarly journals Radiomics analysis of myocardial perfusion SPECT images in patients with cardiomyopathy and heart failure

2021 ◽  
Vol 22 (Supplement_3) ◽  
Author(s):  
K Okuda ◽  
K Nakajima ◽  
H Saito ◽  
S Yamashita ◽  
M Hashimoto ◽  
...  
Keyword(s):  
Heart Failure ◽  
Myocardial Perfusion ◽  
Single Photon ◽  
Photon Emission ◽  
Myocardial Perfusion Spect ◽  
Feature Reduction ◽  
Support Vector ◽  
Emission Computed Tomography ◽  
Operating Characteristics ◽  
Perfusion Spect

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI Grants Background Although myocardial perfusion heterogeneity due to focally damaged cardiomyocytes is observed in single−photon emission computed tomography (SPECT) imaging, a current perfusion defect scoring system does not allow us to provide sufficient diagnostic information for heterogeneity. Purpose The aim of this study was to perform radiomics analysis of myocardial perfusion SPECT (MPS) images to investigate the potential to detect myocardial perfusion heterogeneity. Methods Patients with hypertrophic cardiomyopathy (n = 3), heart failure (n = 9), and with a low likelihood of coronary artery disease (n =15) (Figure 1), who underwent a rest 99mTc-MIBI myocardial perfusion SPECT, were assessed using a LIFEx software. Four shape−based features, 6 histogram−based features, and 32 textural features were computed. The relevant features for the classification of the patients were selected using the Boruta algorithm, and hierarchical clustering of the selected features using the Spearman correlation coefficient was also performed for the feature reduction. The receiver operating characteristics (ROC) analysis was performed by the support vector machine to calculate the area under the ROC curve (AUC) for the selected features. Results Of 40 features, 17 were selected by the classification analysis, and these features were classified into 7 classes by the correlation analysis (Figure 2). The ROC AUCs for 7 features extracted from each class were 0.99, 0.97, 0.96, 0.92, 0.90, 0.86, and 0.83 for the contrast of NDGLDM, the entropy of histogram, ZLNU of GLZLM, the energy of GLCM, the energy of histogram, SZLGE of GLZLM, and the correlation of GLCM, respectively, as compared to 0.39 for a summed rest score. Conclusions Radiomics analysis successfully determined the myocardial perfusion heterogeneity in patients with cardiomyopathy and heart failure. It might be promising for the evaluation of myocardial damages that cannot be analyzed by the conventional scoring method.

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