State and Recent Progress of Nuclear Cardiology in China

Abstract

In this review, we focus mainly on the clinical applications of myocardial perfusion imaging (MPI) with single-photon emission CT (SPECT) and metabolic imaging in clinical practice. Important advances have been made in the clinical applications of MPI, including its role in stratifying risk and guiding management decisions. The impact of incomplete and complete myocardial ischemia correction on long-term outcomes was analyzed and compared with complete and incomplete diseased vessel intervention. Importantly, a new pharmacologic stress testing agent—higenamine—was developed and has completed phase III clinical trials. Ventricular synchrony was assessed by phase analysis of gated MPI in healthy Chinese subjects and in patients with or without left ventricular (LV) dysfunction. Finally, the clinical value of technetium (99mTc) sestamibi SPECT and fludeoxyglucose (18F-FDG) positron emission tomography (PET) in patients with LV aneurysms was deeply investigated. Viability of LV aneurysm in patients with ischemic cardiomyopathy was a negative independent predictor of survival. The diagnostic accuracy of LV parameters analyzed by both gated SPECT and gated PET was investigated in patients with LV aneurysm, who revealed severe perfusion defects and LV remodeling. Additionally, end-systolic volume measured by gated PET was the only independent predictor of cardiac death among all the LV functional parameters evaluated by gated SPECT, gated PET, cardiac magnetic resonance imaging, and echocardiography.