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Concepts of PET, SPECT, and MRI in the Assessment of Myocardial Viability Leading to PET/MRI Application

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Molecular and Multimodality Imaging in Cardiovascular Disease

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Abstract

The prevalence of heart failure is continuously rising in view of the increasingly elderly population and improved survival of acute coronary syndrome patients. Although heart failure can be related to various causes such as idiopathic cardiomyopathy, valvular disease, hypertensive, and diabetic heart disease, ischemic heart disease is the predominant cause of the majority of patients with heart failure symptoms. Exercise-induced and repetitive myocardial ischemia commonly induces cumulative myocardial stunning-hibernation that over time may manifest clinically as left ventricular dysfunction with heart failure symptoms. Stunning-hibernation myocardium may completely or partially restore its function in a substantial number of patients, in whom coronary flow is restored by interventional or surgical revascularization. The identification of stunning-hibernation myocardium, or ischemic compromised viable but dysfunctional myocardial regions, with imaging is critical for the clinical assessment of ischemic heart failure patients. There is a variety of cardiac imaging modalities to identify stunning-hibernation myocardium. This chapter emphasizes on the concepts of PET, SPECT, and MRI in the assessment of myocardial viability leading to the advantages of PET/MRI application. In addition, clinical determinants such as timely revascularization of ischemic, jeopardized but viable myocardium, effects of advanced stages of myocardial remodeling, ischemic conditioning, and the extent of left-ventricular dilation will be given considerations.

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Acknowledgement

Some sections of the manuscript may be similar to sections of an extensive review of cardiac PET by Valenta et al. [33]

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Authors and Affiliations

  1. Department of Radiology SOM, Nuclear Medicine, Johns Hopkins University, Baltimore, MA, USA

    Ines Valenta MD

  2. Johns Hopkins University, Radiology School of Medicine, Cardiovascular Nuclear Medicine, Baltimore, MD, USA

    Thomas Hellmut Schindler MD

  3. Department of Nuclear Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

    Xiaoli Zhang MD, PhD

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  1. Ines Valenta MD
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  2. Xiaoli Zhang MD, PhD
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Correspondence to Thomas Hellmut Schindler MD .

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Editors and Affiliations

  1. Johns Hopkins University, Radiology School of Medicine, Cardiovascular Nuclear Medicine, Baltimore, Maryland, USA

    Thomas H. Schindler

  2. Johns Hopkins University, School of Medicine, Cardiology, Baltimore, Maryland, USA

    Richard T. George

  3. Radiology and Epidemiology, Johns Hopkins University, School of Medicine, Cardiology, Baltimore, Maryland, USA

    Joao A.C. Lima

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Valenta, I., Zhang, X., Schindler, T.H. (2015). Concepts of PET, SPECT, and MRI in the Assessment of Myocardial Viability Leading to PET/MRI Application. In: Schindler, T., George, R., Lima, J. (eds) Molecular and Multimodality Imaging in Cardiovascular Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-19611-4_6

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  • DOI: https://doi.org/10.1007/978-3-319-19611-4_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19610-7

  • Online ISBN: 978-3-319-19611-4

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