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The role of nuclear cardiac imaging in risk stratification of sudden cardiac death

  • Review Article
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Sudden cardiac death (SCD) represents a significant portion of all cardiac deaths. Current guidelines focus mainly on left ventricular ejection fraction (LVEF) as the main criterion for SCD risk stratification and management. However, LVEF alone lacks both sensitivity and specificity in stratifying patients. Recent research has provided interesting data which supports a greater role for advanced cardiac imaging in risk stratification and patient management. In this article, we will focus on nuclear cardiac imaging, including left ventricular function assessment, myocardial perfusion imaging, myocardial blood flow quantification, metabolic imaging, and neurohormonal imaging. We will discuss how these can be used to better understand SCD and better stratify patient with both ischemic and non-ischemic cardiomyopathy.

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Abbreviations

CFR:

Coronary flow reserve

CS:

Cardiac sarcoidosis

DCM:

Dilated cardiomyopathy

HCM:

Hypertrophic cardiomyopathy

H/M:

Heart-to-mediastinum ratio

MBF:

Myocardial blood flow

MPI:

Myocardial perfusion imaging

SDS:

Sum difference score

SRS:

Sum rest score

SSS:

Sum stress score

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Acknowledgments

RSB is a career investigator supported by the Heart and Stroke Foundation of Ontario, a Tier 1 Research Chair supported by the University of Ottawa, and the University of Ottawa Heart Institute Vered Chair in Cardiology. DJ is a Cardiac Imaging Fellow at the University of Ottawa Heart Institute supported by a grant from the CHUM and CHUM Foundation. JK is supported by the Centre of Excellence of Cardiovascular and Metabolic Disease, Academy of Finland.

Disclosures

RSB is or has been a consultant for and receives grant funding from GE Healthcare, Lantheus Medical Imaging, and Jubilant DraxImage. TDR receives research grant funding from GE Healthcare, Advanced Accelerator Applications, and AstraZeneca. BJC holds the Saul and Edna Goldfarb Chair in Cardiac Imaging Research. He receives research support from GE Healthcare and educational support from TeraRecon Inc. JK has been a consultant of Lantheus Medical Imaging and received a grant from CardiRad Inc.

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Authors and Affiliations

  1. National Cardiac PET Centre, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada

    Daniel Juneau MD, FRCPC, Fernanda Erthal MD, Benjamin J. W. Chow MD, FRCPC, FACC, FASNC, Calum Redpath MBChB, PhD, Terrence D. Ruddy MD, FRCPC, FACC, FASNC & Rob S. Beanlands MD, FRCPC, FACC

  2. Turku PET Centre, Turku University Hospital and University of Turku, Turku, Finland

    Juhani Knuuti MD, PhD

  3. Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, QC, Canada

    Daniel Juneau MD, FRCPC

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  1. Daniel Juneau MD, FRCPC
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  2. Fernanda Erthal MD
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  3. Benjamin J. W. Chow MD, FRCPC, FACC, FASNC
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  4. Calum Redpath MBChB, PhD
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  5. Terrence D. Ruddy MD, FRCPC, FACC, FASNC
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  7. Rob S. Beanlands MD, FRCPC, FACC
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Correspondence to Daniel Juneau MD, FRCPC.

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Juneau, D., Erthal, F., Chow, B.J.W. et al. The role of nuclear cardiac imaging in risk stratification of sudden cardiac death. J. Nucl. Cardiol. 23, 1380–1398 (2016). https://doi.org/10.1007/s12350-016-0599-8

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