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Nuclear Investigation in Heart Failure and Myocardial Viability

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Abstract

Heart failure (HF) is evolving as an enormous cardiovascular health problem worldwide. In the United States alone, five million patients suffer from symptomatic disease, and more than half a million patients are newly diagnosed with HF every year. There are at least one million hospitalizations that result in 6.5 million hospital days and nearly 300,000 deaths each year. The total inpatient and outpatient costs for HF are approximately $35 billion. It has been increasingly realized that a much larger number of subjects may harbor asymptomatic ventricular dysfunction, and an enormous number may suffer from diseases that render them susceptible to the development of HF. Therefore, it is important that clinicians are able to predict the evolution and progression of the disease so that appropriate preventive measures are undertaken. The recommendations of the American College of Cardiology–American Heart Association emphasize the development of management strategies that will prevent the evolution of HF in those who are susceptible to or suffer from asymptomatic left ventricular dysfunction. For this purpose, various novel strategies are being developed for the identification of neurohumoral alterations that form the basis of ventricular remodeling. The development of new radiotracers represents an important first step toward targeted molecular imaging and image-guided therapy in HF patients. In this chapter, we describe one such molecular imaging strategy, the development of an angiotensin-converting enzyme (ACE) inhibitor that binds specifically to myocardial ACE in the heart and will help identify patients who are susceptible to HF development. This may lead to a new generation of imaging probes for monitoring disease progression and the effectiveness of treatments for HF.

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Author information

Authors and Affiliations

  1. Medicine and Radiology, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Vasken Dilsizian M.D. (Professor)

  2. Division of Nuclear Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA

    Vasken Dilsizian M.D. (Chief)

  3. Cardiology, Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai School of Medicine, New York, NY, USA

    Jagat Narula M.D., Ph.D. (Philip J. and Harriet L. Goodhart Chair)

  4. Medicine, Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai School of Medicine, New York, NY, USA

    Jagat Narula M.D., Ph.D. (Professor)

  5. Global Health, Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai School of Medicine, New York, NY, USA

    Jagat Narula M.D., Ph.D. (Associate Dean)

  6. Cardiovascular Imaging Program, Zena and Michael A. Wiener Cardiovascular Institute Mount Sinai School of Medicine, New York, NY, USA

    Jagat Narula M.D., Ph.D. (Director)

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  1. Vasken Dilsizian M.D.
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Editor information

Editors and Affiliations

  1. School of Medicine, Dept. Diagnostic Radiology, University Maryland, S. Greene Street 22, Baltimore, 21201, Maryland, USA

    Vasken Dilsizian

  2. , Department of Cardiology, Mount Sinai School of Medicine and Medic, Gustave L. Levy Place 1, New York, 10029, New York, USA

    Jagat Narula

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Dilsizian, V., Dilsizian, V., Narula, J., Narula, J., Narula, J., Narula, J. (2013). Nuclear Investigation in Heart Failure and Myocardial Viability. In: Dilsizian, V., Narula, J. (eds) Atlas of Nuclear Cardiology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5551-6_9

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  • DOI: https://doi.org/10.1007/978-1-4614-5551-6_9

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