[Apoptosis detection in cardiovascular diseases through nuclear cardiology SPECT images]

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.