Abstract
This thesis provides farsighted insights in the presence of cardiac sympathetic denervation in different patient groups, the outcome of patients with denervation and the value of SPECT and PET in predicting outcome.
Cardiac amyloidosis is associated with denervation and therefore belonging to one of these indications. Imaging of cardiac sympathetic innervation is of interest in these patients, since amyloid depositions can be present along the sympathetic nerves, and thus leading to electromechanical dissociation. Chapter 2 and 3 investigate the use of [123I]-MIBG for the visualization of denervation in patients with cardiac amyloidosis.
Chapter 4 focuses on the use of [123I]-MIBG for denervation imaging in patients with end-stage chronic kidney failure, who make the transition from the pre-dialysis phase to maintenance hemodialysis (HD). Cardiac sympathetic innervation appears to be already disrupted before the start of maintenance HD.
A third group of interest for cardiac sympathetic innervation imaging is patients with (non-) ischemic heart failure, especially regarding to risk on ventricular arrhythmia and response to resynchronization therapy (CRT). Chapter 5 describes the use of [11C]-mHED in patients with ischemic cardiomyopathy, treated with prophylactic implantable cardioverter defibrillator. Chapter 6 investigates the use of [11C]-mHED in patients with non-ischemic cardiomyopathy treated with CRT.
In Chapter 7 the value of [18F]-FDOPA is evaluated in detecting cardiac metastases and the relationship of these metastases to the presence of typical characteristics of carcinoid heart disease on echocardiography.
Chapter 8 focusses on future perspectives of imaging cardiac sympathetic innervation, with respect to better identification of patients at risk.
Cardiac amyloidosis is associated with denervation and therefore belonging to one of these indications. Imaging of cardiac sympathetic innervation is of interest in these patients, since amyloid depositions can be present along the sympathetic nerves, and thus leading to electromechanical dissociation. Chapter 2 and 3 investigate the use of [123I]-MIBG for the visualization of denervation in patients with cardiac amyloidosis.
Chapter 4 focuses on the use of [123I]-MIBG for denervation imaging in patients with end-stage chronic kidney failure, who make the transition from the pre-dialysis phase to maintenance hemodialysis (HD). Cardiac sympathetic innervation appears to be already disrupted before the start of maintenance HD.
A third group of interest for cardiac sympathetic innervation imaging is patients with (non-) ischemic heart failure, especially regarding to risk on ventricular arrhythmia and response to resynchronization therapy (CRT). Chapter 5 describes the use of [11C]-mHED in patients with ischemic cardiomyopathy, treated with prophylactic implantable cardioverter defibrillator. Chapter 6 investigates the use of [11C]-mHED in patients with non-ischemic cardiomyopathy treated with CRT.
In Chapter 7 the value of [18F]-FDOPA is evaluated in detecting cardiac metastases and the relationship of these metastases to the presence of typical characteristics of carcinoid heart disease on echocardiography.
Chapter 8 focusses on future perspectives of imaging cardiac sympathetic innervation, with respect to better identification of patients at risk.
| Translated title of the contribution | SPECT en PET in Sympathische Innervatie |
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| Original language | English |
| Qualification | Doctor of Philosophy |
| Awarding Institution |
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| Supervisors/Advisors |
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| Award date | 29-Apr-2015 |
| Place of Publication | [S.l.] |
| Publisher | |
| Print ISBNs | 978-90-367-7614-1 |
| Electronic ISBNs | 978-90-367-7613-4 |
| Publication status | Published - 2015 |