Leiden University Scholarly Publications

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Henneman, M.M. (2008)

Multimodality imaging in chronic coronary artery disease

Doctoral Thesis
Various non-invasive imaging techniques are available for the diagnosis of coronary artery disease (CAD). Multi-slice computed tomography (MSCT) is an upcoming technique that allows direct visualization of the coronary arteries. Apart from the assessment of atherosclerosis, MSCT can also provide important information on the global and regional left ventricular (LV) function. However, it should be realized that the hemodynamic consequences of atherosclerosis can not be obtained by MSCT imaging, and that functional testing, with for example nuclear imaging, will remain necessary to determine therapeutic strategy. CAD is the most common cause of chronic heart failure. Recently, cardiac resynchronization therapy (CRT) has become implemented in the treatment of patients with severe heart failure. Although the improvement in systolic function after CRT implantation can be considerable, 20% to 30% of patients do not respond to CRT. It has been shown that the presence of LV dyssynchrony is...Show moreVarious non-invasive imaging techniques are available for the diagnosis of coronary artery disease (CAD). Multi-slice computed tomography (MSCT) is an upcoming technique that allows direct visualization of the coronary arteries. Apart from the assessment of atherosclerosis, MSCT can also provide important information on the global and regional left ventricular (LV) function. However, it should be realized that the hemodynamic consequences of atherosclerosis can not be obtained by MSCT imaging, and that functional testing, with for example nuclear imaging, will remain necessary to determine therapeutic strategy. CAD is the most common cause of chronic heart failure. Recently, cardiac resynchronization therapy (CRT) has become implemented in the treatment of patients with severe heart failure. Although the improvement in systolic function after CRT implantation can be considerable, 20% to 30% of patients do not respond to CRT. It has been shown that the presence of LV dyssynchrony is an important predictor of response to CRT. Gated SPECT allows not only the assessment of myocardial perfusion (scar tissue and viable myocardium) but also the evaluation of LV dyssynchrony. As many patients with heart failure undergo nuclear imaging with SPECT, integrated assessment of LV dyssynchrony, viability and scar tissue may be an attractive option.Show less
Cardiac resynchronization therapy
Computed tomography
Coronary artery disease
Dyssynchrony
Heart failure
Left ventricular function
Myocardial perfusion
Nuclear imaging
All authors
Henneman, M.M.
Supervisor
Bax, J.J.; Jukema, J.W.
Co-supervisor
Schuijf, J.D.
Qualification
Doctor (dr.)
Awarding Institution
Leiden University Medical Center (LUMC), Leiden University
Date
2008-12-18
ISBN (print)
9789090236872

Funding

Sponsorship
AstraZeneca BV, Biotronik Nederland BV, Boehringer Ingelheim BV, Boston Scientific BV, Bristol-Myers Squibb BV, Eli Lilly Nederland BV, GE Healthcare Medical Diagnostics, J.E. Jurriaanse Stichting, Medtronic Trading NL BV, Menarini Farma Nederland, Merck Sharp & Dohme BV, Novartis Pharma BV, Pfizer BV, Schering-Plough BV, Servier Farma BV, St. Jude Medical Nederland BV, Stichting EMEX, Toshiba Medical Systems Nederland, the Netherlands Heart Foundation, the Interuniversity Cardiology Institute of the Netherlands