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Apoptosis is a biological process of death or cellular suicide present in all the cells of the metazoans. It maintains the balance between the regeneration of pluripotential cells -or stem cells- and the elimination of cells that have already served their function, of cells that have reproduced in excess, or have been genetically damaged beyond repair. Apoptosis activation in cardiomyocytes is a common problem in a large variety of cardiomyopathies; it has been suggested that it is an important contributor ventricular hypertrophy and to the increase of the infarct size in patients with cardiac failure and cardiovascular disease. Clinical diagnosis of apoptosis is a reality in the medical science, its application in different aspects of cardiology includes from coronary cardiopathy to rhythm alterations. In this sense, the use of the non-invasive imaging, can be very useful for the in vivo detection of this type of cellular death in patients with myocardial necrosis, acute myocardial infarct, acute rejection of cardiac transplantation, myocarditis, intracardial malignant tumours, as well as in cardiotoxicity cases and other cardiomyopathies. Particularly, binding of Tc99m-labeled Annexin V, produces gammagraphic images that allow the identification of apoptotic cells in vivo in SPECT and SestaMiBi systems. In summary, the use of these techniques will be invaluable in the near future for anti-apoptosis therapy and intervention in the routine of the daily Cardiology practice.

Apoptosis is a biological process of death or cellular suicide present in all the cells of the metazoans. It maintains the balance between the regeneration of pluripotential cells -or stem cells- and the elimination of cells that have already served their function, of cells that have reproduced in excess, or have been genetically damaged beyond repair. Apoptosis activation in cardiomyocytes is a common problem in a large variety of cardiomyopathies; it has been suggested that it is an important contributor ventricular hypertrophy and to the increase of the infarct size in patients with cardiac failure and cardiovascular disease. Clinical diagnosis of apoptosis is a reality in the medical science, its application in different aspects of cardiology includes from coronary cardiopathy to rhythm alterations. In this sense, the use of the non-invasive imaging, can be very useful for the in vivo detection of this type of cellular death in patients with myocardial necrosis, acute myocardial infarct, acute rejection of cardiac transplantation, myocarditis, intracardial malignant tumours, as well as in cardiotoxicity cases and other cardiomyopathies. Particularly, binding of Tc99m-labeled Annexin V, produces gammagraphic images that allow the identification of apoptotic cells in vivo in SPECT and SestaMiBi systems. In summary, the use of these techniques will be invaluable in the near future for anti-apoptosis therapy and intervention in the routine of the daily Cardiology practice. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is a major cause of morbidity and mortality in end-stage renal disease (ESRD). Renal transplant is known to improve left ventricle hypertrophy and systolic dysfunction in selected groups of patients. Methods: We assessed myocardial perfusion, wall motion and functional parameters by single photon emission computed tomography (SPECT) and Gated-SPECT in 30 consecutive ESRD patients with normal coronary angiograms before and after renal transplantation. Results: Uremic cardiomyopathy improved significantly after the transplant. The proportion of patients with angina decreased from 26 to 0%; the frequency of cardiomegaly decreased from 57 to 20% (p <0.01); the frequency of segments with perfusion defects decreased from 42.7 to 10.2% (p <0.001); the proportion of patients with low left ventricular ejection fraction (LVEF) dropped from 53.3 to 20% (p <0.001); and mean LVEF increased from (48.0 ± 9.7% to 58.2 ± 8.2%). Similarly, the proportion of segments showing systolic wall thickening, hypokinesia and dyskinesia also decreased significantly after renal transplant (p <0.01). Conclusions: Uremic cardiomyopathy may be potentially reversible in patients with normal angiographic coronary arteries after renal transplant in a relatively short period of time. SPECT and Gated-SPECT are objective gateway methods to determine myocardial perfusion, hypokinesia, dyskinesia, and functional parameters (left ventricular ejection fraction and systolic wall thickening) and may be useful to establish diagnostic, coronariographic, prognostic, and therapeutic indications. [Copyright &y& Elsevier]