Abstract
This chapter reviews the anatomic, physiologic features of circulatory system comprising both the cardiovascular system and the lymphatic system. The pathophysiology of relevant cardiac and lymphatic diseases will be discussed. This is followed by the review of the role of radionuclide imaging in the diagnosis and management of these diseases such as coronary artery disease, acute ischemic syndromes, heart failure, and lymphedema. The pertinent radiotracers and imaging instruments, and the clinical circumstances under which these tools are applied to clinical decision making will be reviewed in correlation with the pathophysiologic changes. We discuss the usefulness of particular techniques in the management of patients with coronary artery disease, including assessment of myocardial perfusion, contractility, viability, and detection of unstable atherosclerotic plaques. Radioisotope imaging in the diagnostic workup of infective endocarditis, as well as cardiac sarcoidosis and amyloidosis are also included.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Parmley WW, Wikman-Coffelt J (1991) Physiology of cardiac muscle contraction. In: Parmley WW, Chatterjee K (eds) Cardiology. Lippincott, Philadelphia, pp 1–26
Parmley WW (1991) Ventricular function. In: Parmley WW, Chatterjee K (eds) Cardiology. Lippincott, Philadelphia, pp 1–20
Duncker DJ, Bache RJ (2008) Regulation of coronary blood flow during exercise. Physiol Rev 88:1009–1086
Tune JD (2014) Coronary circulation. Morgan & Claypool Life Sciences, San Francisco
Ardehali A, Ports TA (1990) Myocardial oxygen supply and demand. Chest 98:699–705
Goodwill AG, Dick GM, Kiel AM, Tune JD (2017) Regulation of coronary blood flow. Compr Physiol 7(2):321–382
Schelbert HR (2010) Anatomy and physiology of coronary blood flow. J Nucl Cardiol 17:545–554
Niccoli G, Scalone G, Crea F (2015) Acute myocardial infarction with no obstructive coronary atherosclerosis: mechanisms and management. Eur Heart J 36:475
Campisi R, Czernin J, Schoder H, Sayre JW, Schelbert HR (1999) L-arginine normalizes coronary vasomotion in long-term smokers. Circulation 99:491–497
Schindler TH, Nitzsche EU, Munzel T, Olschewski M, Brink I, Jeserich M et al (2003) Coronary vasoregulation in patients with various risk factors in response to cold pressor testing: contrasting myocardial blood flow responses to short- and long-term vitamin C administration. J Am Coll Cardiol 42:814–822
Gould KL, Nakagawa Y, Nakagawa K, Sdringola S, Hess MJ, Haynie M et al (2000) Frequency and clinical implications of fluid dynamically significant diffuse coronary artery disease manifest as graded, longitudinal, base-to-apex myocardial perfusion abnormalities by noninvasive positron emission tomography. Circulation 101:1931–1939
Cecchi F, Olivotto I, Gistri R, Lorenzoni R, Chiriatti G, Camici PG (2003) Coronary microvascular dysfunction and prognosis in hypertrophic cardiomyopathy. N Engl J Med 349:1027–1035
Neglia D, Michelassi C, Trivieri MG, Sambuceti G, Giorgetti A, Pratali L et al (2002) Prognostic role of myocardial blood flow impairment in idiopathic left ventricular dysfunction. Circulation 105:186–193
Bombardini T (2005) Myocardial contractility in the echo lab: molecular, cellular and pathophysiological basis. Cardiovasc Ultrasound 3:27. https://doi.org/10.1186/1476-7120-3-27
Dandel M, Hetzer R (2021) Ventricular systolic dysfunction with and without altered myocardial contractility: clinical value of echocardiography for diagnosis and therapeutic decision-making. Int J Cardiol 327:236–250
Miranda D, Lewis GD, Fifer MA (2016) Heart failure, Chapter 9. In: Lilly LS (ed) Pathophysiology of heart disease: a collaborative project of medical students and faculty, 6th edn. Wolters Kluwer, Alphen aan den Rijn, pp 220–248
Gazewood JD, Turner PL (2017) Heart failure with preserved ejection fraction: diagnosis and management. Am Fam Physician 96(9):582–588
Hartupee J, Mann DL (2017) Neurohormonal activation in heart failure with reduced ejection fraction. Nat Rev Cardiol 14(1):30–38
Hayley BD, Burwash IG (2012) Heart failure with normal left ventricular ejection fraction: role of echocardiography. Curr Opin Cardiol 27(2):169–180
Patel PA, Ali N (2017) Mechanisms involved in regulation of systemic blood pressure. Arch Clin Hypertension 3(1):016–020
Harrison DG, Florentine MS, Brooks LA et al (1988) The effect of hypertension and left ventricular hyper trophy on the lower range of coronary autoregulation. Circulation 77:1108
Oktay AA, Shah SJ (2014) Current perspectives on systemic hypertension in heart failure with preserved ejection fraction. Curr Cardiol Rep 16:545. https://doi.org/10.1007/s11886-014-0545-9
Franch RH, Gravanis MB (1993) Pulmonary hypertension and core pulmonale. In: Gravanis M (ed) Cardiovascular disorders: pathogenesis and pathophysiology. Mosby, St Louis, pp 139–177
Haworth SG (1987) Pulmonary vascular disease in ventricular septal defect: structural and functional correlations in lung biopsies from 85 patients with outcome of intracardiac repair. J Pathol 152:157–168
Sharma GV, McIntyre KM, Sharma S et al (1984) Clinical and hemodynamic correlates in pulmonary embolism. Clin Chest Med 5(421):37
Palevsky HI, Weiss DW (1990) Pulmonary hypertension secondary to chronic thromboembolism. J Nucl Med 31:1–9
Fishman AP (1988) Pulmonary hypertension and cor pulmonale. In: Fishman AP (ed) Pulmonary diseases and disorders, 2nd edn. McGraw-Hill, New York
Dunnill MS (1961) An assessment of the anatomical factor in cor pulmonale in emphysema. J Clin Pathol 14:246
Berger HJ, Matthay RA, Lake J et al (1978) Assessment of cardiac performance with quantitative radionuclide angiocardiography: right ventricular ejection fraction with reference to findings in chronic obstructive pulmonary disease. Am J Cardiol 41:897–905
Grossman W (1991) Diastolic dysfunction in congestive heart failure. N Engl J Med 325:1557
McGill HC Jr, McMahan CA, Herderick EE, Malcom GT, Tracy RE, Strong JP (2000) Origin of atherosclerosis in childhood and adolescence. Am J Clin Nutr 72(5 Suppl):1307S–1315S
Tegos TJ, Kalodiki E, Sabetai MM, Nicolaides AN (2001) The genesis of atherosclerosis and risk factors: a review. Angiology 52(2):89–98
Shahawy S, Libby P (2016) Atherosclerosis, Chapter 5. In: Lilly LS (ed) Pathophysiology of heart disease: a collaborative project of medical students and faculty, 6th edn. Wolters Kluwer, Alphen aan den Rijn, pp 112–133
Moore KJ, Sheedy FJ, Fisher EA (2013) Macrophages in atherosclerosis: a dynamic balance. Nat Rev Immunol 13(10):709–721
Borén J, Chapman MJ, Krauss RM, Packard CJ, Bentzon JF et al (2020) Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J 41:2313–2330
He C, Medley S, Hu T, Hindstale ME, Lupu F, Virmani R, Olsen LE (2015) PDGFRβ signalling regulates local inflammation and synergizes with hypercholesterolaemia to promote atherosclerosis. Nat Commun 6:7770
Ramji DP, Davies TS (2015) Cytokines in atherosclerosis: key players in all stages of disease and promising therapeutic targets. Cytokine Growth Factor Rev 26(6):673–685
Ward MR, Pasterkamp G, Yeung AC, Borst C (2000) Arterial remodeling mechanisms and clinical implications. Circulation 102:1186–1191
Wilder J, Sabatine MS, Lilly LS (2016) Ischemic heart disease, Chapter 6. In: Lilly LS (ed) Pathophysiology of heart disease: a collaborative project of medical students and faculty, 6th edn. Wolters Kluwer, Alphen aan den Rijn, pp 134–161
Croce K, Libby P (2007) Intertwining of thrombosis and inflammation in atherosclerosis. Curr Opin Hematol 14:55–61
Libby P (2013) Mechanisms of acute coronary syndromes. N Engl J Med 369:883–884
Antonopoulos AS, Goliopoulou A, Vogiatzi G, Tousoulis D (2018) Myocardial oxygen consumption, Chapter 2.2. In: Tousoulis D (ed) Coronary artery disease from biology to clinical practice. Academic, New York, pp 127–136
Cannon RO 3rd. (1998) Role of nitric oxide in cardiovascular disease: focus on the endothelium. Clin Chem 44(8 Pt 2):1809–1819
Arbustini E, Narula J, Tavazzi J et al (2014) The MOGE(S) classification of cardiomyopathy or clinicians. J Am Coll Cardiol 64:304–318
Garfinkel AC, Seidman JG, Seidman CE (2018) Genetic pathogenesis of hypertrophic and dilated cardiomyopathy. Heart Failure Clin 14:139–146
Maron BJ, Ommen SR, Semsarian C et al (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99
Rammos A, Meladinis V, Vovas G, Patsouras D (2017) Restrictive cardiomyopathies: the importance of noninvasive cardiac imaging modalities in diagnosis and treatment—a systematic review. Radiol Res Pract 2017:2874902
Jung HO (2012) Pericardial effusion and pericardiocentesis: role of echocardiography. Korean Circ J 42(11):725–734
Vakamudi S, Ho N, Cremer PC (2017) Pericardial effusions: causes, diagnosis, and management. Prog Cardiovasc Dis 59(4):380–388
Cheong XP, Law L, Seow SC, Tay L, Tan HC, Yeo WT, Low AF, Kojodjojo P (2020) Causes and prognosis of symptomatic pericardial effusions treated by pericardiocentesis in an Asian academic medical centre. Singap Med J 61(3):137–141
Albugami S, Al-Husayni F, AlMalki A, Dumyati M, Zakri Y, AlRahimi J (2020) Etiology of pericardial effusion and outcomes post pericardiocentesis in the western region of Saudi Arabia: a single-center experience. Cureus 12:e6627
Sachpekidis V, Moralidis E, Arsos G (2018) Equilibrium radionuclide ventriculography: still a clinically useful method for the assessment of cardiac function? Hell J Nucl Med 21(3):213–220
Heiba SI, Cerqueira MD (1994) Evaluation of cardiac function. In: Cerqueira MD (ed) Nuclear cardiology. Blackwell Scientific, Cambridge, pp 53–117
Soufer A, Liu C, Henry ML, Baldassarre LA (2020) Nuclear cardiology in the context of multimodality imaging to detect cardiac toxicity from cancer therapeutics: established and emerging methods. J Nucl Cardiol 27:1210–1224
Berger HJ, Zaret BL (1984) Radionuclide assessment of cardiovascular performance. In: Freeman L (ed) Freeman and Johnson’s clinical radionuclide imaging. Saunders, Philadelphia
Berman DS, Maddahi J, Garcia EV et al (1981) Assessment of left and right ventricular function with multiple gated equilibrium cardiac blood pool scintig raphy. In: Berman DS, Mason DT (eds) Clinical nuclear cardiology. Grune and Stratton, New York
Scatteia A, Silverio A, Padalino R, De Stefano F, America R, Cappelletti AM et al (2021) Non-invasive assessment of left ventricle ejection fraction: where do we stand? J Pers Med 11(11):1153
Liu YH, Fazzone-Chettiar R, Sandoval V et al (2021) New approach for quantification of left ventricular function from low-dose gated bloodpool SPECT: validation and comparison with conventional methods in patients. J Nucl Cardiol 28:939–950
Ramon AJ, Yang Y, Wernick MN, Pretorius PH, Johnson KL, Slomka PJ, King MA (2020) Evaluation of the effect of reducing administered activity on assessment of function in cardiac gated SPECT. J Nucl Cardiol 27(2):562–572
Gould KL, Lipscomb K, Hamilton GW (1974) A physiological basis for assessing critical coronary stenosis: instantaneous flow response and regional distribution during coronary hyperemia as measures of coronary flow reserve. Am J Cardiol 33:84
Maddahi J, Rodrigues E, Kiat J, Van Train KF, Berman DS (1995) Detection and evaluation of coronary artery disease by thallium-201 myocardial perfusion scintigraphy. In: DePuey EG, Berman DS, Garcia E (eds) Cardiac SPECT imaging. Raven, New York
Okada RD (1988) Myocardial kinetics of technetium-99m hexakis 2-methoxyl 2 methylopropylisonitrile. Circulation 77:491
Berman DS, Kiat H, Friedman JD, Wang FP, Van Train K, Metzer L, Maddahi J, Germano G (1993) Separate acquisition rest thallium-201/stress technetium 99m sestamibi dual-isotope myocardial perfusion single-photon emission computed tomography: a clinical validation study. J Am Coll Cardiol 22:1455–1464
Seldin DW, Johnson LL, Blood DK (1989) Myocardial perfusion imaging with technetium-99m SQ30217: comparison with thallium-201 and coronary anatomy. J Nucl Med 30:312–319
Henzlova MJ, Machac J (1994) Clinical utility of technetium-99m-teboroxime myocardial washout imaging. J Nucl Med 35:575–579
Fang W, Liu S (2019) New 99mTc radiotracers for myocardial perfusion imaging by SPECT. Curr Radiopharm 12:171–186
Saha GB (2018) Radiopharmaceuticals and general methods of radiolabeling. In: Fundamentals of nuclear pharmacy. Springer, Cham, pp 93–121
Norenberg JP (2021) Fundamentals of medical radionuclides. In: Remington. Academic, New York, pp 187–204
Vilcant V, Zeltser R (2022) Treadmill stress testing. In: StatPearls [Internet]. StatPearls Publishing, Treasure Island
Heiba SI, Jacobson AF, Cerqueira MD, Shattuc S, Sharma S (1999) The additive values of radionuclide ventriculography and extent of myocardium at risk to dipyridamole thallium-201 imaging for optimal risk stratification prior to vascular surgery. Nucl Med Commun 20:887–894
Mann A, Williams J (2020) Considerations for stress testing performed in conjunction with myocardial perfusion imaging. J Nucl Med Technol 48:114–121
Wasserman K, Hansen JE, Sue DY et al (2012) Principles of exercise testing and interpretation, 5th edn. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia
Farell MB (2016) Myocardial perfusion imaging 2015: quality, safety, and dose optimization. Society of Nuclear Medicine and Molecular Imaging Technologist Section, Reston
Heller GV, Hendel R, Mann A (2009) Nuclear cardiology: technical applications. McGraw Hill, New York
Roger VL, Jacobsen SI, Pelikka PA et al (1998) Prognostic value of treadmill exercise testing. a population based study in Olmsted County, Minnesota. Circulation 98:2836–2841
Young M, Pan W, Wiesner J et al (1994) Characterization of arbutamine: a novel catecholamine stress agent for diagnosis of coronary artery disease. Drug Dev Res 32:19–28
Iskandrian AS, Verani MS, Heo J (1994) Pharmacologic stress testing: mechanism of action, hemodynamic responses, and results in detection of coronary artery disease. J Nucl Cardiol 1:94–111
Lieu HD, Shryock JC, von Mering GO et al (2007) Regadenoson, a selective A2A adenosine receptor agonist, causes dose-dependent increases in coronary blood flow velocity in humans. J Nucl Cardiol 14:514–520
Iskandrian AE, Bateman TM, Belardinelli L et al (2007) Adenosine versus regadenoson comparative evaluation in myocardial perfusion imaging: results of the ADVANCE phase 3 multicenter international trial. J Nucl Cardiol 14:645–658
Cerqueira MD, Nguyen P, Staehr P et al (2008) Effects of age, gender, obesity and diabetes on the efficacy and safety of the selective A2A agonist, regadenoson versus adenosine in myocardial perfusion imaging: integrated ADVANCE-MPI trial results. JACC Cardiovasc Imaging 1:207–216
Travin MI, Wexler JP (1999) Pharmacological stress testing. Semin Nucl Med 29:298–318
Vitola JV, Brambatti JC, Caligaris F et al (2001) Exercise supplementation to dipyridamole prevents hypotension, improves electrocardiogram sensitivity, and increases heart-to-liver activity ratio on Tc-99m sestamibi imaging. J Nucl Cardiol 8:652–659
Pennell DJ, Mavrogeni SI, Forbat SM et al (1995) Adenosine combined with dynamic exercise for myocardial perfusion imaging. J Am Coll Cardiol 25:1300–1309
Kiat H, VanTrain KF, Friedman JD et al (1992) Quantitative stress-redistribution thallium-201 SPECT using prone imaging: methodologic development and validation. J Nucl Med 33:1509–1512
Hayes SW, DeLorenzo A, Hachamovich R et al (2003) Prognostic implications of combined prone and supine myocardial perfusion SPECT. J Nucl Med 44:1633–1640
DePuey EG (1994) How to detect and avoid myocardial perfusion SPECT artifacts. J Nucl Med 35:699–702
Neumann DR, Go RT, Myers BA et al (1993) Parametric phase display for biventricular function from gated cardiac blood pool single-photon emission tomography. Eur J Nucl Med 20:1108–1111
Chen J, Garcia EV, Folks RD et al (2005) Onset of left ventricular contraction determined by phase analysis of ECG-gated myocardial perfusion SPECT imaging: development of a diagnostic tool for assessment of cardiac mechanical dyssynchrony. J Nucl Cardiol 6:687–695
Samad Z, Atchley AE, Trimble MA et al (2011) Prevalence and predictors of mechanical dyssynchrony as defined by phase analysis in patients with left ventricular dysfunction undergoing gated SPECT myocardial perfusion imaging. J Nucl Cardiol 18:24–30
Bateman TM, O’Keefe JH Jr, Dong VM et al (1995) Coronary angiographic rates after stress single photon emission computed tomographic scintigraphy. J Nucl Cardiol 2:217–223
Hachamovich R, Berman DS, Shaw IJ et al (1998) Incremental prognostic value of myocardial perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratification for risk of cardiac death and myocardial infarction. Circulation 97:535–543
Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary artery disease. N Engl J Med 300:1350
Hachamovitch R, Berman DS, Kiat H et al (1996) Exercise myocardial perfusion SPECT in patients without known CAD. Incremental prognostic value and use in risk stratification. Circulation 93:905–914
Bateman TM (1997) Clinical relevance of a normal myocardial perfusion scintigraphic study. J Nucl Cardiol 4:172–173
Iskander S, Iskandrian AE (1998) Risk assessment using single-photon emission computed tomographic technetium-99m sestamibi imaging. J Am Coll Cardiol 32:57–62
Mazzanti M, Germano G, Kiat H (1997) Identification of severe and extensive coronary artery disease by automatic measurement of transient ischemic dilatation of the left ventricle in dual isotope myocardial perfusion SPECT. J Am Coll Cardiol 27:1612–1620
Gerson MC, Gerson MC (1997) Test accuracy, test selection, and test result interpretation in chronic coronary artery disease, Chap 20. In: Gerson MC (ed) Cardiac nuclear medicine, 3rd edn. McGraw-Hill, New York
Farkouh ME, Smars RA, Reeder GS, Zinsmeiter AR, Evans RW, Meloy TD, Kopecky SL, Allen M, Allison TG, Gibons RJ, Gabriel SE (1998) A clinical trial of a chest-pain observation unit for patients with unstable angina. N Engl J Med 339:1882–1888
Tatum JL, Jesse RI, Kontros MC et al (1997) Comprehensive strategy for the evaluation and triage of the chest pain patient. Ann Emerg Med 29:116–125
Heller GV, Stowers SA, Hendel RC et al (1998) Clinical value of acute rest technetium-99m tetrofosmin tomographic myocardial perfusion imaging in patients with acute chest pain and nondiagnostic electrocardiograms. J Am Coll Cardiol 31:1011–1017
Boden WE, O’Rourke RA, Crawford MH et al (1998) Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy. Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQUISH) Trial Investigation. N Engl J Med 338:1785–1792
Mahmarian JJ, Mahmarian AC, Marks GF et al (1995) Role of adenosine thallium-201 tomography for defining long-term risk in patients after acute myocardial infarction. J Am Coll Cardiol 25:1333–1340
Iskandrian AE, Hage FG, Shaw LJ, Mahmarian JJ, Berman DS (2014) Serial myocardial perfusion imaging: defining a significant change and targeting management decisions. JACC Cardiovasc Imaging 7:79–96
Gibbons RJ, Balady GJ, Bricker TJ et al (2002) ACC/AHA guideline update for exercise testing: summary article—a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol 40:1531–1540
Young JD (1998) Cardiac transplantation: three decades of experience defines our challenge. Transplant Proc 30:1885–1888
Oyer PE, Stinson EB, Jamieson SW et al (1983) Cyclosporine in cardiac transplantation: 2 and 1/2 year follow-up. Transplant Proc 15:2546–2552
Mairesse GH, Marwick TH, Hanet C et al (1995) Use of exercise electrocardiography, technetium-99m MIBI perfusion tomography for coronary disease surveillance in a low-prevalence population of heart transplant recipients. J Heart Lung Transplant 14:222–229
Fang JC, Roco T, Jarcho J et al (1998) Noninvasive assessment of transplant-associated arteriosclerosis. Am Heart J 125:980–987
Manapragada PP, Andrikopoulou E, Bajaj N, Bhambhvani P (2021) PET cardiac imaging (perfusion, viability, sarcoidosis, and infection). Radiol Clin N Am 59:835–852
Bateman TM, Dilsizian V, Beanlands RS et al (2016) American Society of Nuclear Cardiology and Society of Nuclear Medicine and molecular imaging joint position statement on the clinical indications for myocardial perfusion PET. J Nucl Cardiol 23(5):1227–1231
Schelbert HR, Wisenberg G, Phelps ME et al (1982) Noninvasive assessment of coronary stenoses by myocardial imaging during pharmacologic coronary vasodilation, VI: detection of coronary artery disease in human beings with intravenous N-13 ammonia and positron computed tomography. Am J Cardiol 49:1197–1207
Monahan WG, Tilbury RS, Laughlin JS (1972) Uptake of H-13 labeled ammonia. J Nucl Med 13:274
Bergmann SR, Hack S, Tewson T et al (1980) The dependence of accumulation of N-13-NH3 by myocardium on metabolic factors and its implications for quantitative assessment of perfusion. Circulation 61:34
Gould KL, Schelberth H, Phelps H et al (1979) Noninvasive assessment of coronary stenosis with myocardial perfusion imaging during pharmacologic coronary vasodilation. V. Detection of 47 percent diameter coronary stenosis with intravenous N-14 ammonia and emission-computed tomography in intact dogs. Am J Cardiol 43:200
Tamaki N, Yonekura Y, Senda M et al (1985) Myocardial positron computed tomography with N-13 ammonia. Eur J Nucl Med 11:246–251
Selwyn AP, Allan RM, L’Abbate A et al (1982) Relation between regional myocardial uptake of rubidium-82 and perfusion: absolute reduction of cation uptake in ischemia. Am J Cardiol 50:112–121
Goldstein RA, Mullani NA, Marani SK et al (1983) Myocardial perfusion with rubidium-82. II. Effects of metabolic and pharmacological interventions. J Nucl Med 24:907–915
Schelbert HR, Ashburn WL, Chauncey DM et al (1977) Comparative myocardial uptake of intravenously administered radionuclides. J Nucl Med 15:1092
Gould KL (1978) Assessment of coronary stenoses by myocardial perfusion imaging during pharmacologic coronary vasodilatation. IV. Limits of stenosis detection by idealized experimental, cross-sectional myocardial imaging. Am J Cardiol 42:761–768
Maddahi J, Czernin J, Lazewatsky J et al (2011) Phase I, first-in-human study of BMS747158, a novel F18-labeled tracer for myocardial perfusion PET: dosimetry, biodistribution, safety, and imaging characteristics after a single injection at rest. J Nucl Med 52:1490–1498
Berman DS, Maddahi J, Tamarappoo BK et al (2013) Phase II safety and clinical comparison with single-photon emission computed tomography myocardial perfusion imaging for detection of coronary artery disease. J Am Coll Cardiol 61:469–477
Wackers FJ, Soufer R, Zaret BL et al (2012) Nuclear cardiology. In: Mann Z, Bonow L (eds) Braunwald’s heart disease: a textbook of cardiovascular medicine. Elsevier/Saunders, Philadelphia, pp 293–339
Santos BS, Ferreira MJ (2019) Positron emission tomography in ischemic heart disease. Rev Port Cardiol 38(8):599–608
Momose M, Kondo C (2007) Assessment of myocardial viability by FDG-PET. Rinsho Byori 55:639–647
Blume ED, Altmann K, Mayer JE et al (1999) Evolution of risk factors influencing early mortality of the arterial switch operation. J Am Coll Cardiol 33:1702–1709
Gould KL (1991) PET perfusion imaging and nuclear cardiology. J Nucl Med 32:579–606
Arrighi JA, Dione DP, Condos S et al (1999) Adenosine Tc-99m sestamibi SPECT underestimates ischemia compared with N-13 ammonia PET in a chronic canine model of ischemia. J Nucl Med 40:6P (abstract)
Di Carli M, Czernin J, Hoh CK et al (1995) Relation among stenosis severity, myocardial blood flow, and flow reserve in patients with coronary artery disease. Circulation 91:1944–1951
Bateman TM, Heller GV, McGhie AI et al (2006) Diagnostic accuracy of res/stress ECG-gated Rb-82 myocardial perfusion PET: comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 13:24–33
Jaarsma C, Leiner T, Bekkers SC et al (2012) Diagnostic performance of noninvasive myocardial perfusion imaging using single-photon emission computed tomography, cardiac magnetic resonance, and positron emission tomography imaging for the detection of obstructive coronary artery disease: a meta-analysis. J Am Coll Cardiol 59:1719–1728
Mc Ardle BA, Dowsley TF, deKemp RA et al (2012) Does rubidium-82PET have superior accuracy to SPECT perfusion imaging for the diagnosis of obstructive coronary disease? A systematic review and meta-analysis. J Am Coll Cardiol 60:1828–1737
Bateman TM, Heller GV, McGhie AI et al (2005) Attenuation-corrected Tc-99m sestamibi SPECT compared with Rb-82 myocardial perfusion PET. J NuclCardiol 12:S118 (abstract)
Bateman TM, Heller GV, McGhie AI et al (2006) Diagnostic accuracy of rest/stress ECG-gated Rb-82 myocardial perfusion PET: comparison with ECG-gated Tc-99m sestamibi SPECT. J Nucl Cardiol 13(1):24–33
Danad I, Raijmakers PG, Driessen RS, Leipsic J, Raju R, Naoum C et al (2017) Comparison of coronary CT angiography, SPECT, PET, and hybrid imaging for diagnosis of ischemic heart disease determined by fractional flow reserve. JAMA Cardiol 2:1100–1107
Angelidis G, Giamouzis G, Karagiannis G, Butler J, Tsougos I et al (2017) SPECT and PET in ischemic heart failure. Heart Fail Rev 22(2):243–261
Dorbala S, Vangala D, Sampson U et al (2007) Value of vasodilator ventricular ejection fraction reserve in evaluating the magnitude of myocardium at risk and the extent of angiographic coronary artery disease: a 82Rb PET/CT study. J Nucl Med 48:349–358
Danad I, Uusitalo V, Kero T et al (2014) Quantitative assessment of myocardial perfusion in the detection of significant coronary artery disease: cutoff values and diagnostic accuracyof quantitative [(15)O]H2O PET imaging. J Am Coll Cardiol 64:1464–1475
Hajjiri MM, Leavitt MB, Zheng H et al (2009) Comparison of positron emission tomography measurement of adenosine-stimulated absolute myocardial blood flow versus relative myocardialtracer content for physiological assessment of coronary arterystenosis severity and location. JACC Cardiovasc Imaging 2:751–758
Ohira H, Dowsley T, Dwivedi G et al (2014) Quantification of myocardial blood flow using PET to improve the management of patients with stable ischemic coronary artery disease. Future Cardiol 10:611–631
Marwick TH, Shan K, Patel S et al (1997) Incremental value of rubidium-82 positron emission tomography for prognostic assessment of known or suspected coronary artery disease. Am J Cardiol 80:865–870
Yoshinaga K, Chow BJW, de Kemp R et al (2004) Prognostic value of rubidium-82 perfusion positron emission tomography: preliminary results from the consecutive 153 patients. J Am Coll Cardiol 43:338A (abstract)
Chow BJW, Wong JW, Yoshinaga K et al (2005) Prognostic significance of dipyridamole-induced ST depression in patients with normal Rb-82 PET myocardial perfusion imaging. J Nucl Med 46:1095–1101
Nemirovsky D, Henzlova MJ, Machac J et al (2005) Prognosis of normal rubidium-82 myocardial perfusion study. J Nucl Cardiol 12:S118 (abstract)
Yoshinaga K, Chow BJW, Williams K et al (2006) What is the prognostic value of myocardial perfusion imaging using rubidium-82 positron emission tomography? J Am Coll Cardiol 48:1029–1039
Dorbala S, DiCarli MF, Beanlands RS et al (2013) Prognostic value of stress myocardial perfusion positron emission tomography: results from a multicenter observational registry. J Am Coll Cardiol 61:176–184
Kay J, Dorbala S, Goyal A et al (2013) Influence of sex on risk stratification with stress myocardial perfusion Rb-82 positron emission tomography: results from the PET prognosis multicenter registry. J Am Coll Cardiol 62:1866–1876
Herzog BA, Husmann L, Valenta I et al (2009) Long-term prognostic value of N13-ammonia myocardial perfusion positron emission tomography: added value of coronary flow reserve. J Am Coll Cardiol 54:150–156
Dorbala S, Hachamovich R, Curillova Z et al (2009) Incremental value of gated Rb-82 positron emission tomography myocardial imaging over clinical variables and rest LVEF. J Am Coll Cardiol Imaging 2:846–854
Dorbala S, Di Carli MF (2014) Cardiac PET perfusion: prognosis,risk stratification, and clinical management. Semin Nucl Med 44:344–357
Shaw LJ, Iskandrian AE (2004) Prognostic value of gated myocardialperfusion SPECT. J Nucl Cardiol 11:171–185
Hachamovitch R, Hayes S, Friedman JD et al (2003) Determinants of risk and its temporal variation in patients with normal stress myocardial perfusion scans: what is the warranty period of anormal scan? J Am Coll Cardiol 41:1329–1340
Pethig K, Heublein B, Meliss RR et al (1999) Volumetric remodeling of the proximal left coronary artery: early versus late after heart transplantation. J Am Coll Cardiol 34:197–203
Julius BK, Vassalli G, Mandonow L et al (1999) Alpha-adrenergic blockade prevents exercise-induced vasoconstriction of stenotic coronary arteries. J Am Coll Cardiol 33:1499–1505
O’Driscoll G, Green D, Maiorana A et al (1999) Improvement in endothelial function by angiotensin-converting enzyme inhibition in non-insulin-dependent diabetes mellitus. J Am Coll Cardiol 33:15–16
Kugiyama K, Motoyama T, Doi H, Kawano H et al (1999) Improvement of endothelial vasomotor dysfunction by treatment with alpha-tocopherol in patients with high remnant lipoproteins levels. J Am Coll Cardiol 33:1512–1518
Gould KL, Martucci JP, Goldberg DI, Hess MJ, Edens RP, Latifi R, Dudrick SJ (1994) Short-term cholesterol lowering decreases size and severity of perfusion abnormalities by positron emission tomography after dipyridamole in patients with coronary artery disease. A potential noninvasive marker of healing coronary endothelium. Circulation 89:1530–1538
Huggins GS, Pasternak RC, Alpert NM et al (1998) Effects of short-term treatment of hyperlipidemia on coronary vasodilator function and myocardial perfusion in regions having substantial impairment of baseline dilator reverse. Circulation 98:1291–1296
Yokoyama J, Memomura S, Oktake T, Yonekura K et al (1999) Improvement of impaired myocardial vasodilation due to diffuse coronary atherosclerosis in hypercholesterolemics after lipid-lowering therapy. Circulation 100:117–122
Gould KL, Martucci JP, Goldberg DL et al (1994) Short-term cholesterol lowering decreases disease in patients on a regimen of intensive physical exercise and low fat diet. J Am Coll Cardiol 19:34–42
Murthy VL, Naya M, Foster CR et al (2011) Improved cardiac riskassessment with noninvasive measures of coronary flow reserve. Circulation 124:2215–1224
Ziadi MC, Dekemp RA, Williams KA et al (2011) Impaired myocar-dial flow reserve on rubidium-82 positron emission tomographyimaging predicts adverse outcomes in patients assessed formyocardial ischemia. J Am Coll Cardiol 58:740–748
Murthy VL, Lee BC, Sitek A et al (2014) Comparison and prognosticvalidation of multiple methods of quantification of myocardialblood flow with 82Rb PET. J Nucl Med 55:1952–1958
Taqueti VR, Di Carli MF (2015) Radionuclide myocardial perfusion imaging for the evaluation of patients with known or suspectedcoronary artery disease in the era of multimodality cardiovascular imaging. Prog Cardiovasc Dis 57:644–653
Schinkel AF, Bax JJ, Poldermans D et al (2007) Hibernating myocardium: diagnosis and patient outcomes. Curr Probl Cardiol 32:375–410
Underwood SR, Bax JJ, vom Dahl J et al (2004) Imaging techniques for the assessment of myocardial hibernation report of a study group of the European Society of Cardiology. Eur Heart J 25:815–836
Schinkel AF, Bax JJ, Delgado V et al (2010) Clinical relevance of hiber-nating myocardium in ischemic left ventricular dysfunction. Am J Med 123:978–986
Beanlands RS, Ruddy TD, deKemp RA et al (2002) Positron emission tomography and recovery following revascularization (PARR-1):the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function. J Am Coll Cardiol 40:1735–1743
D’Egidio G, Nichol G, Williams KA et al (2009) Increasing benefit from revascularization is associated with increasing amounts of myocardial hibernation: a substudy of the PARR-2 trial. JACC Cardiovasc Imaging 2:1060–1068
Ohira H, Mc Ardle B, Cocker MS et al (2013) Current and future clinical applications of cardiac positron emission tomography. Circ J 77:836–848
Ben Bouallègue F, Maïmoun L, Kucharczak F et al (2021) Left ventricle function assessment using gated first-pass 18F-FDG PET: validation against equilibrium radionuclide angiography. J Nucl Cardiol 28:594–603
Sauer WH, Stern BJ, Baughman RP, Culver DA, Royal W (2017) High-risk sarcoidosis: current concepts and research imperatives. Ann Am Thorac Soc 14:S437–S444
Ramirez R, Trivieri M, Fayad ZA, Ahmadi A, Narula J, Argulian E (2019) Advanced imaging in cardiac sarcoidosis. J Nucl Med 60(7):892–898
Ramsay SC, Cuscaden C (2020) The current status of quantitative SPECT/CT in the assessment of transthyretin cardiac amyloidosis. J Nucl Cardiol 27(5):1464–1468
Okasha O, Kazmirczak F, Chen KHA, Farzaneh-Far A, Shenoy C (2019) Myocardial involvement in patients with histologically diagnosed cardiac sarcoidosis: a systematic review and meta-analysis of gross pathological images from autopsy or cardiac transplantation cases. J Am Heart Assoc 8(10):e011253
Youssef G, Leung E, Mylonas I et al (2012) The use of 18F-FDG PET in the diagnosis of cardiac sarcoidosis: a systematic review and metaanalysis including the Ontario experience. J Nucl Med 53:241–248
White JA, Rajchl M, Butler J, Thompson RT, Prato FS, Wisenberg G (2013) Active cardiac sarcoidosis: first clinical experience of simultaneous positron emission tomography--magnetic resonance imaging for the diagnosis of cardiac disease. Circulation 127:e639–e641
Cegła P, Ciepłucha A, Pachowicz M, Chrapko B, Piotrowski T, Lesiak M (2020) Nuclear cardiology: an overview of radioisotope techniques used in the diagnostic workup of cardiovascular disorders. Kardiol Pol 78:520–528
Hotta M, Minamimoto R, Awaya T, Hiroe M, Okazaki O, Hiroi Y (2020) Radionuclide imaging of cardiac amyloidosis and sarcoidosis: roles and characteristics of various tracers. Radiographics 40(7):2029–2041
Martinez-Naharro A, Baksi AJ, Hawkins PN, Fontana M (2020) Diagnostic imaging of cardiac amyloidosis. Nat Rev Cardiol 17:413–426
Fontana M, Ćorović A, Scully P, Moon JC (2019) Myocardial amyloidosis: the exemplar interstitial disease. JACC Cardiovasc Imaging 12(11 Part 2):2345–2356
Kyriakou P, Mouselimis D, Tsarouchas A, Rigopoulos A, Bakogiannis C, Noutsias M, Vassilikos V (2018) Diagnosis of cardiac amyloidosis: a systematic review on the role of imaging and biomarkers. BMC Cardiovasc Disord 18(1):1–11
Shaw LJ, Raggi P, Schisterman E et al (2003) Prognostic value of cardiac risk factors and coronary calcium screening for all-cause mortality. Radiology 228:826–833
Berman DS, Wong ND, Gransar H et al (2004) Relationship between stress-induced myocardial ischemia and atherosclerosis measured by coronary calcium tomography. J Am Coll Cardiol 44:923–930
Kim JH, Machac J, Travis A et al (2013) Coronary artery and thoracic aorta calcification is inversely related to coronary flow reserve as measured by Rb-82 PET/CT in intermediate risk patients. J Nucl Cardiol 20(3):375–384. https://doi.org/10.1007/s12350-013-9702-6
Schenker MP, Dorbala S, Hong EC et al (2008) Interrelation of coronary calcification, myocardial ischemia, and outcomes in patients with intermediate likelihood of coronary artery disease. Circulation 117:1693–1700
Bolli R (1990) Mechanism of myocardial stunning. Circulation 82:723–772
Ferrari R, LaCanna G, Giubbini R et al (1994) Left ventricular dysfunction due to stunning and hibernation in patients. Cardiovasc Drugs Ther 8(Suppl 2):371–380
Fuster V, Badimon L, Badimon JJ et al (1992) The pathogenesis of coronary artery disease and the acute coronary syndromes. N Engl J Med 326(242–250):310–318
Homans DC, Laxson DD, Sublett E et al (1989) Cumulative deterioration of myocardial function after repeated episodes of exercise-induced ischemia. Am J Phys 256:H1462–H1471
Shivalkar B, Flameng W, Szilard M et al (1999) Repeated stunning precedes myocardial hibernation in progressive multiple coronary artery stenosis. J Am Coll Cardiol 34:2126–2136
Brunken R, Tillisch J, Schwaiger M et al (1986) Regional perfusion, glucose metabolism, and wall motion in patients with chronic electrocardiographic Q-wave infarctions: evidence for persistence of viable tissue in some infarct regions by positron emission tomography. Circulation 73:951–963
Partington SL, Kwong RY, Dorbala S (2011) Multimodality imaging in the assessment of myocardial viability. Heart Fail Rev 16:381–395
Smart S, Wynsen J, Sagar K (1997) Dobutamine-atropine stress echocardiography for reversible dysfunction during the first week after myocardial infarction: limitations and determinations of accuracy. J Am Coll Cardiol 30:1669–1678
Bax JJ, Wijns W, Cornel JH et al (1997) Accuracy of currently available techniques for prediction of functional recovery after revascularization in patients with left ventricular dysfunction due to chronic coronary artery disease: comparison of pooled data. J Am Coll Cardiol 30:1451–1460
Dilsizian V, Bonow RO (1992) Differential uptake and apparent Tl-201 washout after thallium reinjection: options regarding early redistribution imaging before reinjection or late redistribution imaging after reinjection. Circulation 85:1032–1038
Dilsizian V, Bonow RO (1993) Current diagnostic techniques of assessing myocardial viability in patients with hibernating and stunned myocardium. Circulation 87:1–20
Dilsizian V, Rocco TP, Freedman NMT et al (1990) Enhanced detection of ischemic but viable myocardium by the reinjection of thallium after stress-redistribution imaging. N Engl J Med 323:141–146
Dilsizian V, Freedman NMT, Bacharach SL et al (1992) Regional thallium uptake in irreversible defects: magnitude of change in thallium activity after reinjection distinguishes viable from nonviable myocardium. Circulation 85:627–634
Perrone-Filardi P, Bacharach SL, Dilsizian V et al (1992) Regional left ventricular wall thickening: relation to regional uptake of F-18-fluorodeoxyglucose and Tl-201 in patients with chronic coronary artery disease and left ventricular dysfunction. Circulation 86:1125–1137
Romero J, Xue X, Gonzalez W, Garcia MJ (2012) CMR imaging assessing viability in patients with chronic ventricular dysfunction due to coronary artery disease: a meta-analysis of prospective trials. JACC Cardiovasc Imaging 5:494–508
Schinkel AF, Bax JJ, Poldermans D, Elhendy A, Ferrari R, Rahimtoola SH (2007) Hibernating myocardium: diagnosis and patient outcomes. Curr Probl Cardiol 32:375–410
Maes A, Flameng W, Nuyts J et al (1994) Histological alterations in chronically hypoperfused myocardium: correlation with PET findings. Circulation 90(735–745):208
Kim YK, Lee DS, Cheon J et al (1999) Myocardial viability assessment by nitroglycerine gated Tc-99m MIBI SPECT: comparison with rest-24-hour redistribution Tl-201 SPECT. J Nucl Med 40:1P (abstract)
Gunning MG, Anagnostopoulos C, Knight CJ et al (1998) Comparison of Tl-201, Tc-99m-tetrofosmin, and dobutamine magnetic resonance imaging for identifying hibernating myocardium. Circulation 98:1869–1874
Perrone-Filardy P, Bacharach S, Dilsizian V et al (1994) Clinical significance of regional myocardial glucose uptake in regions with normal blood flow in patients with chronic coronary artery disease. J Am Coll Cardiol 23:608–616
Fallavolita JA, Canty JM (1997) F-18 FDG utilization is regionally increased in fasting pigs with hibernating myocardium. J Am Coll Cardiol 29:130A (abstract)
Hansen CL, Corbett JR, Pippin JJ et al (1988) 123-I-phenylpentadecanoic acid and single photon emission computed tomography in identifying LV regional metabolic abnormalities in patients with coronary heart disease: comparison with thallium-201 myocardial tomography. J Am Coll Cardiol 12:78–87
Hansen CL, Rastogi A, Sangrigoli R et al (1998) On myocardial perfusion, metabolism, and viability. J Nucl Cardiol 5:202–204
Beanlands RSB, Ruddy TD, deKemp RA et al (2002) Positron emission tomography and recovery following revascularization (PARR-1): the importance of scar and the development of a prediction rule for the degree of recovery of left ventricular function. J Am Coll Cardiol 40:1735–1743
Beanlands RSB, Nichol G, Huszti E et al (2007) F-18-fluorodeoxyglucose positron emission tomography imaging-assisted management of patients with severe left ventricular dysfunction and suspected coronary disease: a randomized, controlled trial (PARR-2). J Am Coll Cardiol 50:2002–2012
Bonow RO, Maurer G, Lee KL et al (2011) Myocardial viability and survival in ischemic left ventricular dysfunction. N Engl J Med 364:1617–1625
Russell RR III, Zaret BL (2006) Nuclear cardiology: present and future. Curr Probl Cardiol 31(9):557–629
Lopaschuk GD et al (2010) Myocardial fatty acid metabolism in health and disease. Physiol Rev 90:207–258
Luyten K, Schoenberger M (2017) Molecular imaging of cardiac metabolism, innervation, and conduction. EMJ Cardiol 5(1):70–78
Taegtmeyer H, Dilsizian V (2013) Imaging cardiac metabolism. In: Atlas of nuclear cardiology. Springer, New York, pp 289–321
Guyton AC, Hall JE (1966) Textbook of medical physiology, 9th edn. Saunders, Philadelphia, pp 193–197
Suami H, Scaglioni MF (2018) Anatomy of the lymphatic system and the lymphosome concept with reference to lymphedema. In: Seminars in plastic surgery, vol 32, No. 1. Thieme Medical Publishers, New York, pp 05–11
Weissleder R, Thrall JH (1989) The lymphatic system: diagnostic imaging studies. Radiology 172:315–317
Weiss L (1988) Cell and tissue biology, 6th edn. Urban and Schwarzenberg, Baltimore, pp 499–514
Ruggiero R, Muz J, Fietsam R Jr (1993) Reestablishment of lymphatic drainage after canine lung transplantation. J Thorac Cardiovasc Surg 106:167–171
Ruggiero R, Fietsam R Jr, Thomas GA (1994) Detection of canine allograft lung rejection by pulmonary lymphoscintigraphy. J Thorac Cardiovasc Surg 108:253
Suami H, Pan WR, Mann GB, Taylor GI (2008) The lymphatic anatomy of the breast and its implications foe sentinel lymph node biopsy: a human cadaver study. Ann Surg Oncol 15:863–871
Leak LV (1970) Electron microscopic observations on lymphatic capillaries and the structural components of the connective tissue lymph interface. Microvasc Res 2:361–391
Clodius L (1990) Lymphedema. In: McCarthy JG (ed) Plastic surgery. Saunders, Philadelphia, pp 4093–4120
Aspelund A, Robciuc MR, Karaman S, Makinen T, Alitalo K (2016) Lymphatic system in cardiovascular medicine. Circ Res 118(3):515–530
Zuther JE, Norton S (2013) Lymphedema management. The comprehensive guide for practitioners, 3rd edn. Thieme Medical Publishers, New York
Warren AG, Brorson H, Borud LJ, Slavin SA (2007) Lymphedema. Ann Plast Surg 59:464–472
Chen SL, Iddings DM, Scheri RP, Bilchik AJ (2006) Lymphatic mapping and sentinel node analysis: current concepts and applications. CA Cancer J Clin 56:292–309
Krag DN, Anderson SJ, Julian TB et al (2010) Sentinel-lymph-node resection compared with conventional axillary-lymphnode dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial. Lancet Oncol 11:927–933
Nawaz MK, Hamad MM, Abdel-Dayem HM (1990) Tc-99m human serum albumin lymphoscintigraphy in lymphedema of the lower extremities. Clin Nucl Med 15:794–799
Szuba A, Shin WS, Strauss HW, Rockson S (2003) The third circulation: radionuclide lymphoscintigraphy in the evaluation of lymphedema. J Nucl Med 44(1):43–57
Mavi A, Lakhani P, Zhuang H, Gupta NC, Alavi A (2005) Fluorodeoxyglucose-PET in characterizing solitary pulmonary nodules, assessing pleural diseases and the initial staging, restaging, therapy planning, and monitoring response of lung cancer. Radiol Clin N Am 43(1):1–24
Koolen BB, Valdés ORA, Vogel WV et al (2012) 18F-FDG PET/CT for the assessment of locoregional lymph node involvement and radiotherapy indication in stage II-III breast cancer treated with neoadjuvant chemotherapy. Cancer Res 72:nr:P4–02–01 (abstract)
Rijke AM, Croft BY, Johnson RA (1990) Lymphoscintigraphy and lymphedema of the lower extremities. J Nucl Med 31:990–998
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Elgazzar, A.H., Alenezi, S.A., Elfawal, M.A. (2022). Circulatory System (Cardiovascular and Lymphatic Systems). In: Elgazzar, A.H. (eds) The Pathophysiologic Basis of Nuclear Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-96252-4_9
Download citation
DOI: https://doi.org/10.1007/978-3-030-96252-4_9
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-96251-7
Online ISBN: 978-3-030-96252-4
eBook Packages: MedicineMedicine (R0)