Non-invasive cardiovascular imaging plays an important role in examination of patients with chronic coronary syndrome. Positron emission tomography (PET) has the highest diagnostic accuracy and prognostic significance due to the ability to assess myocardial blood flow (MBF) and coronary flow reserve (CFR). These physiological processes provide myocardial oxygen demand, both at rest and stress, as well as maintaining sufficient myocardial circulation during coronary artery constriction. At the same time, the high cost and low availability of assessing MBF and CFR by PET do not allow widespread use of this approach in clinical practice. The use of modern gamma cameras with cadmium zinc telluride detectors can be an alternative to PET. The aim of the review is to present fundamental information about MBF and CFR, as well as about the possibilities of using scintigraphy for determination of these parameters and their clinical significance.

Aim: To study the relationship of microcirculatory changes in coronary bed and electrocardiographic and laboratory signs of damage to myocardium in patients with acute myocardial infarction (AMI).Methods. The observational study included patients with newly emerged AMI. Depending on the ECG changes, the patients were divided into two groups: 1) with ST segment elevation (n = 75) (STEMI) and 2) without ST segment elevation (n = 44) (NSTEMI). All patients underwent electrocardiography, analysis of biochemical markers of myocardial damage, dynamic single photon emission computed tomography (SPECT) and myocardial perfusion imaging.Results. The study included 119 patients (age 62.5 ± 10.4 years, 63% men). STEMI patients had heavier perfusion defects at rest, 5.00 (3.00;9.00) and 0.00 (0.00;1.00), and after pharmacological stress test, 7.00 (5.00;13.00) and 2.50 (0.00;5.00), also they had more reduced stress myocardial blood flow (MBF), 1.09 (0.83;1.59) and 1.67 (1.36;2.46) ml/min/g, flow difference (FD), 0.36 (0.01;0.72) and 1.14 (0.63;1.72) ml/min/g, and myocardial flow reserve (MFR), 1.78 (1.11;2.19) and 2.57 (2.13;3.31), according to compared to NSTEMI patients. Correlation analysis revealed significant relationships between stress MBF and CPK after 24 hours and 4 days: r = –0.34 and r = = –0.31, troponin I upon admission and after 24 hours – r = –0.4 and r = –0.3; MFR and FD and troponin I upon admission – r = –0.41 and r = –0.41.Conclusion. Quantitative parameters of myocardial perfusion determined by early dynamic myocardial SPECT are associated with electrocardiographic changes and biochemical markers of myocardial damage and allow an adequate assessment of the severity of the disease in patients with AMI.

(1) Background: The objective of this study was to determine the optimal post-processing model for dynamic cadmium–zinc–telluride single-photon emission computed tomography (CZT-SPECT). (2) Methods: A total of 235 patients who underwent diagnostic invasive coronary angiography within three months of the SPECT and those who had coronary computed tomography angiography (CCTA) before SPECT (within 3 months) were enrolled in this study. Each SPECT study was processed to obtain global and regional stress myocardial blood flow (sMBF), rest-MBF (rMBF), myocardial flow reserve (MFR) and flow difference (FD) estimates obtained with 1-tissue-compartment (1TCM) and net retention (NR) modes, both with and without attenuation correction. (3) Results: The use of AC led to significantly higher sMBF, rMBF and DF values obtained by 1TCM compared those values derived by 1TCM with NAC; the lowest values of stress MBF and rest MBF were obtained by 1TCM_NAC. The resting flow, MFR and DF were significantly (p < 0.005) higher in the AC model than in NAC. All quantitative variables were significantly (p < 0.05) higher in NR_NAC than in the 1TC_NAC model. Finally, sMBF, rMBF and FD showed significantly (p < 0.05) higher values by using 1TMC_AC compared to NR_AC. (4) Conclusions: We suggested that 1-compartment and net retention models correctly reflect coronary microcirculation and can be used for clinical practice for evaluating quantitative myocardial perfusion by dynamic SPECT. Attenuation correction is an important step in post-processing dynamic SPECT data, which increases the consistency and diagnostic accuracy of models.

The article is devoted to the analysis of the current status of nuclear cardiology in the Russian Federation. The data on the number of facilities performing radionuclide investigations for the diagnosis and monitoring of the treatment of cardiovascular diseases, their staffing and equipment are given. The statistics of the conducted nuclear cardiology tests for 2018-2020 are given, as well as their methods, features and diagnostic significance are described.