Molecular Imaging of Valvular Diseases and Cardiac Device Infection

Circ Cardiovasc Imaging. 2023 Jan;16(1):e014652. doi: 10.1161/CIRCIMAGING.122.014652. Epub 2023 Jan 17.

Abstract

The use of positron emission tomography imaging with 18F-fluorodeoxyglucose in the diagnostic workup of patients with suspected prosthetic valve endocarditis and cardiac device infection (implantable electronic device and left ventricular assist device) is gaining momentum in clinical practice. However, in the absence of prospective randomized trials, guideline recommendations about 18F-fluorodeoxyglucose positron emission tomography in this setting are currently largely based on expert opinion. Measurement of aortic valve microcalcification occurring as a healing response to valvular inflammation using 18F-sodium fluoride positron emission tomography represents another promising clinical approach, which is associated with both the risk of native valve stenosis progression and bioprosthetic valve degeneration in research trials. In this review, we consider the role of molecular imaging in cardiac valvular diseases, including aortic stenosis and valvular endocarditis, as well as cardiac device infections.

Keywords: 18F-fluorodeoxyglucose; 18F-sodium fluoride; aortic stenosis; infective endocarditis; positron emission tomography.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Defibrillators, Implantable*
  • Endocarditis* / diagnostic imaging
  • Endocarditis, Bacterial*
  • Fluorodeoxyglucose F18
  • Heart Valve Diseases* / diagnostic imaging
  • Heart Valve Prosthesis* / adverse effects
  • Humans
  • Molecular Imaging
  • Positron Emission Tomography Computed Tomography / methods
  • Prospective Studies
  • Prosthesis-Related Infections* / diagnostic imaging
  • Prosthesis-Related Infections* / therapy
  • Radiopharmaceuticals

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals