PET in Cardiovascular Diseases
Cardiovascular diseases are known to be the most frequent cause of disability and death in the employable population of the developed countries. In Russia, cardiovascular pathologies account for 55% of deaths. Most common (47%) among these diseases is cor
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Introduction
Cardiovascular diseases are known to be the most frequent cause of disability and death in the employable population of the developed countries. In Russia, cardiovascular pathologies account for 55% of deaths. Most common (47%) among these diseases is coronary heart disease (CHD) (Vyalkov 2002; Oganov and Ya 2002). In Western Europe, the USA, Canada and Australia, mortality from ischemic heart disease has displayed a tendency to decrease over the last several decades. On the contrary, in Russia its growth is being observed. According to the expert committee of the Russian scientific society of cardiologists (2004), only 40–50% of the people who suffer from CHD are aware of their disease and receive adequate treatment, while in 50–60% of cases the disease remains undetected. In this light, it is obvious that improving early diagnosis of cardiovascular diseases with the aid of modern radiological methods can be of significant use in increasing the efficiency of secondary prevention of this pathology. Unfortunately, there still remains the idea in practical cardiology that selective coronography is the “gold standard” in diagnosing ischemic heart disease, since this method provides information on the anatomy of the coronary channel. Meanwhile this technique represents only the state of the intraluminal contour of coronary arteries and does not permit to thoroughly assess the functional significance of coronary stenoses. In addition, the procedure is invasive and may induce a number of complications, the most dangerous of them being hemorrhage from the area of puncture of femoral artery or damage of atherosclerotic plaques in the coronary artery orifices, which can entail embolism and provoke acute coronary syndrome with all consequences up to the lethal outcome. Diagnosing CHD by means of routine noninvasive methods of examination (including electrocardiography, loading electrocardiography [ECG] tests [veloergometry and treadmill test], Holter monitoring and stress-echocardiography) is based on the alteration of the terminal part of the ventricular ECG complex, leftventricular systolic and diastolic dysfunction, rhythm and conduction disorders which can result from transient decrease in myocardial blood flow. Presently the A. Granov et al. (eds.), Positron Emission Tomography, DOI 10.1007/978-3-642-21120-1_20, © Springer-Verlag Berlin Heidelberg 2013
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PET in Cardiovascular Diseases
frequency of false-positive and false-negative results, as well as questionable results, is well-known to be high for ECG stress tests (Belenkov and Ternovoy 2007). Thus, the necessity of improving noninvasive examination methods facilitating early diagnosis of cardiovascular diseases is evident now. The intensive development of modern technologies and improvement of computer techniques over the last two decades have promoted the appearance of substantially new noninvasive methods of examining the cardiovascular system, in particular coronary hemodynamics. These methods have significantly increased th
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