Molecular Imaging of Heart Failure: An Update and Future Trends

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Seminars in nuclear medicine Pub Date : 2024-04-11 DOI:10.1053/j.semnuclmed.2024.03.005
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Abstract

Molecular imaging can detect and quantify pathophysiological processes underlying heart failure, complementing evaluation of cardiac structure and function with other imaging modalities. Targeted tracers have enabled assessment of various cellular and subcellular mechanisms of heart failure aiming for improved phenotyping, risk stratification, and personalized therapy. This review outlines the current status of molecular imaging in heart failure, accompanied with discussion on novel developments. The focus is on radionuclide methods with data from clinical studies. Imaging of myocardial metabolism can identify left ventricle dysfunction caused by myocardial ischemia that may be reversible after revascularization in the presence of viable myocardium. In vivo imaging of active inflammation and amyloid deposition have an established role in the detection of cardiac sarcoidosis and transthyretin amyloidosis. Innervation imaging has well documented prognostic value in predicting heart failure progression and arrhythmias. Tracers specific for inflammation, angiogenesis and myocardial fibrotic activity are in earlier stages of development, but have demonstrated potential value in early characterization of the response to myocardial injury and prediction of cardiac function over time. Early detection of disease activity is a key for transition from medical treatment of clinically overt heart failure towards a personalized approach aimed at supporting repair and preventing progressive cardiac dysfunction.

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心力衰竭的分子成像:最新进展与未来趋势
分子成像可检测和量化心力衰竭的病理生理过程,是对其他成像方法评估心脏结构和功能的补充。靶向示踪剂可评估心衰的各种细胞和亚细胞机制,从而改善表型、风险分层和个性化治疗。本综述概述了心力衰竭分子成像的现状,并讨论了新的发展。重点是放射性核素方法和临床研究数据。心肌代谢成像可识别心肌缺血导致的左心室功能障碍,在有活力的心肌存在的情况下,血管再通后左心室功能障碍可能是可逆的。活动性炎症和淀粉样蛋白沉积的活体成像在检测心脏肉样瘤病和转甲状腺素淀粉样变性方面具有公认的作用。神经支配成像在预测心力衰竭进展和心律失常方面具有很好的预后价值。针对炎症、血管生成和心肌纤维化活动的特异性示踪剂正处于早期开发阶段,但已显示出在早期描述心肌损伤反应和预测心功能随时间变化的潜在价值。疾病活动的早期检测是从临床明显心力衰竭的药物治疗过渡到旨在支持修复和预防渐进性心脏功能障碍的个性化方法的关键。
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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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