Myocardial Innervation

An important target for cardiac molecular imaging is the autonomic nervous system, which exerts both stimulatory (primarily via sympathetic fibers) and inhibitory (primarily via parasympathetic fibers) effects to adjust cardiac performance to meet varying physiological demands. Neuronal dysregulation is associated with increased risk for adverse outcomes such as heart failure progression and unstable rhythms. In this chapter, advances in radionuclide imaging of the autonomic nervous system using both SPECT and PET tracers are reviewed. The focus is on recent successes in this field and the continuing need to translate these discoveries into guidance for integrating the information into therapeutic decision-making.