2018 年 4 巻 1 号 p. 155-162
Nuclear imaging of the failing myocardium is targeting the impaired part related to several processes of myocardial metabolism or work. Myocardium mainly utilizes fatty acid or glucose for ATP production in mitochondria. Intracellular calcium handling, which needs an amount of ATPs, induces myocardial contraction and relaxation, and is regulated with beta adrenal-stimulation. In the failing myocardium, any of these parts related to the myocardial work are variedly impaired, and could be the imaging target. Despite recent advancement of heart failure treatment, the patients with heart failure remain in high morbidity and mortality. For appropriate managements or prediction of prognosis in patients with heart failure, it is important to evaluate the mechanism of the failing myocardium. In this article, we focus on the usefulness of the 2 radionuclide imaging in evaluating sympathetic nerve function using myocardial 123I-MIBG scintigraphy and mitochondrial function using myocardial 99mTc-sestamibi SPECT in the patients with cardiomyopathy.
