Recent Advances and Clinical Applications of PET Cardiac Autonomic Nervous System Imaging.
Recent Advances and Clinical Applications of PET Cardiac Autonomic Nervous System Imaging.
复制标题
DOI：
10.1007/s11886-017-0843-0
复制
发表时间：
2017-04
影响因子：
3.7
通讯作者：
Sinusas AJ
中科院分区：
文献类型：
--
作者：
Boutagy NE;Sinusas AJ
本文综述了正电子发射断层扫描（PET）心脏自主神经系统（ANS）成像的最新进展，特别关注新型和成熟示踪剂的临床应用。[11 C]-间羟麻黄碱（HED）在评价正常和病理心血管功能方面提供了有用的信息。最近，[11 C]-HED PET成像能够预测射血分数降低（HFrEF）心力衰竭患者的致死性心律失常、心源性猝死（SCD）和全因死亡率。此外，初始[11 C]-HED PET成像研究显示，该药物在阐明射血分数保留（HFpEF）的HF患者心脏交感神经系统（SNS）神经支配受损与舒张功能障碍严重程度之间的关系以及预测HFrEF患者对心脏起搏治疗（CRT）的反应方面具有潜力。半衰期更长的18F标记的突触前SNS示踪剂（例如，[18F]-LMI 1195）已被开发以促进临床成像，尽管靶向ANS的PET放射性示踪剂尚未在心血管系统中获得广泛的临床应用。虽然副交感神经系统放射性示踪剂在心脏成像中的应用有限，但新型示踪剂[11 C]-多奈哌齐在初步研究中显示出潜在的实用性。已经合成了许多ANS放射性配体用于PET心脏成像，但迄今为止，临床上最相关的PET示踪剂是[11 C]-HED。最近的研究表明[11 C]-HED在相关临床问题中的效用，例如在HFpEF的难以捉摸的临床综合征中。相反，靶向心脏PNS神经支配的示踪剂在临床上使用较少，但新的示踪剂显示出对未来工作的潜在效用。[11 C]-HED和新设计的18F标记示踪剂在靶向ANS的未来应用有望用于评估和管理各种心血管疾病，包括HFpEF患者的诊断。
The purpose of this review was to summarize current advances in positron emission tomography (PET) cardiac autonomic nervous system (ANS) imaging, with a specific focus on clinical applications of novel and established tracers. [11C]-Meta-hydroxyephedrine (HED) has provided useful information in evaluation of normal and pathological cardiovascular function. Recently, [11C]-HED PET imaging was able to predict lethal arrhythmias, sudden cardiac death (SCD), and all-cause mortality in heart failure patients with reduced ejection fraction (HFrEF). In addition, initial [11C]-HED PET imaging studies have shown the potential of this agent in elucidating the relationship between impaired cardiac sympathetic nervous system (SNS) innervation and the severity of diastolic dysfunction in HF patients with preserved ejection fraction (HFpEF) and in predicting the response to cardiac resynchronization therapy (CRT) in HFrEF patients. Longer half-life 18F-labeled presynaptic SNS tracers (e.g., [18F]-LMI1195) have been developed to facilitate clinical imaging, although no PET radiotracers that target the ANS have gained wide clinical use in the cardiovascular system. Although the use of parasympathetic nervous system radiotracers in cardiac imaging is limited, the novel tracer, [11C]-donepezil, has shown potential utility in initial studies. Many ANS radioligands have been synthesized for PET cardiac imaging, but to date, the most clinically relevant PET tracer has been [11C]-HED. Recent studies have shown the utility of [11C]-HED in relevant clinical issues, such as in the elusive clinical syndrome of HFpEF. Conversely, tracers that target cardiac PNS innervation have been used less clinically, but novel tracers show potential utility for future work. The future application of [11C]-HED and newly designed 18F-labeled tracers for targeting the ANS hold promise for the evaluation and management of a wide range of cardiovascular diseases, including the prognostication of patients with HFpEF.
登录
查看更多内容
影响因子：
4.6
作者：
DELFORGE, J;SYROTA, A;MAZOYER, BM
通讯作者：
MAZOYER, BM
影响因子：
3.1
作者：
DelRosario, RB;Jung, YW;Wieland, DM
通讯作者：
Wieland, DM
影响因子：
3.1
作者：
Capitanio, Selene;Nanni, Cristina;Sambuceti, Gianmario
通讯作者：
Sambuceti, Gianmario
影响因子：
37.8
作者：
DELFORGE, J;JANIER, M;MAZOYER, BM
通讯作者：
MAZOYER, BM
影响因子：
1.5
作者：
Bülow, HP;Stahl, F;Bengel, FM
通讯作者：
Bengel, FM