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• W354430346 abstract "Nuclear cardiology has experienced explosive growth during the past decade, founded on the solid evidence that this discipline provides the clinician with an accurate assessment of patients with suspected ischemic heart disease. Myocardial perfusion SPECT imaging has superior sensitivity and specificity for the detection of coronary artery disease when compared with routine stress testing and provides information regarding the extent, severity, and location of coronary artery disease. The diagnostic value of perfusion imaging has further been improved by the use of gated SPECT and attenuation correction imaging. The latter method provides improved specificity, as well as an enhanced ability to detect multivessel disease. The potential value of SPECT imaging has been extended to patients unable to perform maximal exercise with the use of pharmacologic testing. Adjunctive exercise in conjunction with vasodilator stress improves image quality and significantly reduces side effects. The ongoing development of specific A2a agonists will likely further improve safety and tolerability. The ability of SPECT imaging to risk stratify patients that has served to define nuclear cardiology, as a tool beyond the establishment of a clinical diagnosis. This prognostic information permits the separation of a low-risk cohort of patients from those who are at a high risk for subsequent cardiac events. This information is incremental in nature to clinical and exercise data already available. The risk for myocardial infarction and cardiac death is magnified when high risk scintigraphic findings are present, such as transient ischemic dilation of the left ventricle. In addition to the prognostic applications of perfusion imaging in a general population, this technique has shown specific predictive value in subpopulations, including women and diabetic patients. Furthermore, MPI may be used successfully after acute coronary syndromes, following revascularization, before major surgery, and in patients with a cardiomyopathy. The impact of the predictive value of perfusion imaging is also apparent when examining the costeffectiveness of the technique. Data from a multitude of sources now suggest that perfusion imaging may be used to regulate invasive techniques and provide maximal benefit to patients who most require further intervention while doing so in a financially sound manner. A new series of applications is approaching, using perfusion imaging not only to decide on treatment but also to evaluate the efficacy of these therapies. SPECT imaging has been used as an endpoint for studies examining novel methods of revascularization, such as with the use of laser techniques or angiogenic substances. Nuclear cardiology methods are also expanding beyond myocardial perfusion imaging and encompass a variety of molecular processing including, but not limited to the detection of necrosis and apoptosis, evaluation of adrenergic receptors, definition of atherosclerotic plaque morphology, and targeted imaging of angiogenesis. In conclusion, myocardial perfusion imaging has clearly become a mainstay in the evaluation of patients with known or suspected ischemic heart disease. SPECT imaging offers critical diagnostic and prognostic data for a variety of patient groups and in many different clinical settings. Continued development regarding clinical applications and advances in cardiovascular molecular imaging offer great promise for the future of nuclear cardiology." @default.
• W354430346 created "2016-06-24" @default.
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• W354430346 date "2004-09-20" @default.
• W354430346 modified "2023-09-27" @default.
• W354430346 title "Expanding the Boundaries : Update in Nuclear Cardiology" @default.
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