Single-photon cardiac imaging in patients with cardiac implantable electrical devices
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Department of Cardiology, IRCCS - Azienda Ospedaliero-Universitaria di Bologna - Policlinico di S.Orsola, Bologna, Italy Department of Nuclear Medicine, IRCCS - Azienda Ospedaliero-Universitaria di Bologna Policlinico di S.Orsola, Bologna, Italy Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, Italy
Received Sep 2, 2020; accepted Oct 17, 2020 doi:10.1007/s12350-020-02436-2
Nuclear imaging techniques like single-photon emission computed tomography (SPECT) and radionuclide angiography have wide applications in patients receiving a cardiac implantable electrical device (CIED), who cannot usually undergo cardiac magnetic resonance. Our aim was to provide an update of single-photon imaging clinical applications, with a specific focus on CIED recipients. SPECT imaging is commonly used in CIED patients to assess myocardial perfusion, but it can also be used to evaluate myocardial viability, which is an important predictor of LV function improvement by cardiac resynchronization therapy (CRT). Radionuclide angiography has shown higher temporal resolution and reproducibility than SPECT in the evaluation of cardiac function and dyssynchrony. Left ventricular dyssynchrony as assessed by radionuclide angiography with phase analysis may be reliably used for CRT patient selection and evaluation of CRT response. SPECT imaging with meta-iodo-benzyl-guanidine allows for cardiac sympathetic innervation examination, which may be used for prognostic stratification of heart failure patients and prediction of ventricular tachyarrhythmias. Finally, promising results in CIED infection diagnosis have been shown by SPECT with radiolabeled autologous white blood cells. (J Nucl Cardiol 2020) Key Words: Heart failure Æ SPECT Æ Cardiacinnervation Æ Viability Æ Myocardial blood flow Æ Dyssynchrony Abbreviations CIED Cardiac implantable electrical device CRT Cardiac resynchronization therapy CT Computed tomography EF Ejection fraction 18 FFluor-18-fluorodeoxyglucose positron FDG emission tomography PET Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02436-2) contains supplementary material, which is available to authorized users. This article includes a PowerPoint file that should be made available as ESM on SpringerLink. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations.
LV MIBG RV SPECT WBC
Left ventricular Meta-iodo-benzyl-guanidine Right ventricular Single-photon emission computed tomography White blood cell
The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. Reprint requests: Cinzia Valzania, MD, PhD, Department of Cardiology, IRCCS - Azienda Ospedaliero-Universitaria di Bologna Policlinico di S.Orsola, Bologna, Italy; [email protected] 1071-3581/$34.00 Copyright Ó 2020 American So
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