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Heart Failure

Heart failure, also called congestive heart failure, is a condition in which the heart can no longer pump enough blood or meet the body’s needs for blood and oxygen, especially when the patient is active or exercising. Congestive heart failure is a chronic, long-term condition that may affect the right, left, or both sides of the heart.

There are two types of heart failure:

  • systolic, when the heart muscle cannot pump, or eject, enough  blood out of the heart.
  • diastolic, when the heart muscle is stiff and does not allow the heart to fill up with blood easily.

This compromised pumping action may cause blood to back up in other areas of the body, causing a fluid build-up in the lungs, arms, legs and elsewhere in the body. The lack of oxygen and nutrition being supplied to organs in the body reduces their ability to work properly and may cause organ damage.

The most common cause of heart failure is coronary artery disease (CAD), a narrowing of the  blood vessels that supply blood and oxygen to the heart. Heart failure may also occur when infection weakens the heart muscle, a condition called cardiomyopathy, or as a result of congential heart disease, a heart attack, heart valve disease, and arrhythmia.

How does molecular imaging help people with heart failure?

Molecular and nuclear imaging provides powerful diagnostic and prognostic information on patients with heart failure, including:

Following a heart attack, heart function is assessed using either echocardiography or nuclear imaging.

Molecular and functional imaging procedures assess heart function and provide valuable information on specific biochemical and structural changes in heart tissue including:

  • the extent of scarring
  • degree of coronary artery disease
  • left ventricle remodeling (changes in the size, shape, and function of the heart after injury)
  • the development of congestive heart failure.

Images and information provided by myocardial perfusion imaging, nuclear functional heart study and other molecular imaging procedures help physicians:

  • assess the potential for sudden cardiac death and other cardiac events in patients who have suffered a heart attack or who have chronic heart failure
  • select patients for automatic internal cardiac defibrillators (AICDs).



Molecular imaging is already playing an important role in the diagnosis, management and risk stratification of patients with heart disease. However, we have only seen the beginning of a new and ever expanding frontier using targeted molecular imaging.

Molecular imaging approaches not only complement existing imaging technology, but will also permit the early detection of disease — before changes in physiological function or anatomical structure occur. Molecular imaging will enhance the development and application of truly personalized treatment. Molecular imaging will affect clinical care indirectly by facilitating faster and better drug development and improving the basic understanding of cardiovascular disease.

There are many new and emerging molecular imaging technologies that may help patients with heart disease. In addition to using myocardial perfusion imaging and nuclear functional studies, physicians are using new radiotracers such as  I-123-metaiodobenzylguanidine (MIBG) with SPECT and carbon-11-meta-hydroxyephedrine or carbon-11-mHED with PET to identify the development of congestive heart failure.

Other molecular imaging procedures and technologies under development include:

  • fusion imaging, also called co-registration or hybrid imaging, which allows information from two different studies to be viewed on one image.
  • the use of imaging biomarkers
  • the use of cardiovascular molecular imaging to monitor genetic or stem cell therapy
  • nanomedicine, including the use of laser-activated nanoparticles to destroy atherosclerotic plaque and adult stem cells to rejuvenate arteries.