Cardiac PET imaging for coronary artery disease and heart failure: an overview

This overview surveys where cardiac PET fits across two overlapping problems: coronary artery disease and heart failure.

The authors lay out PET’s strengths — high accuracy for detecting coronary disease, reliable assessment of whether heart muscle is still viable, and a useful role in characterizing the non-ischemic cardiomyopathies that masquerade as ordinary heart failure. The recurring theme is versatility: a single modality that speaks to perfusion, viability, and increasingly to inflammatory and infiltrative disease, with more to come as new radiotracers arrive.

The practical takeaway is that cardiac PET is a robust option across both ischemic and non-ischemic disease, capable of guiding more tailored treatment. The resistance is the familiar one — centers invested in SPECT or echocardiography face cost, training, and workflow hurdles in adopting it.

We rate the evidence low: a narrative overview without original data. Its clinical significance is moderate — PET’s diagnostic breadth is genuinely useful, but availability and cost continue to limit how widely it’s used.