Cardiac applications of radiopharmaceuticals

This chapter discusses the use of radiopharmaceuticals in the study of the heart for both the clinical care for the cardiovascular (CV) patient and advancing CV research. Cardiac morphology and performance are more commonly assessed based on electrocardiographical gating of an myocardial perfusion imaging (MPI) study. A variety of PET radiopharmaceuticals are currently available to assess different aspects of myocardial metabolism. Due to the inherent high sensitivity of the radiopharmaceutical approach and the improved resolution capabilities of hybrid technologies, major advances have been made in the development of radiopharmaceutical-based molecular imaging probes for CV applications. Amyloidosis is a systemic disease with frequent cardiac involvement. Indeed, cardiac amyloidosis is becoming recognized as a significant cause for heart failure with preserved ejection fraction. The detection of myocardial ischemia to diagnose the presence of obstructive coronary artery disease by MPI during stress and rest has been the most common clinical application of nuclear cardiology.