Heart failure is a progressive disorder that results in fluid congestion in the tissues as well as inadequate blood flow. Apoptosis, or programmed cell death, causes a loss of heart muscle cells and contributes to left ventricular dysfunction. Researchers recently discovered that they could noninvasively image apoptosis in heart patients. Because cell loss is potentially reversible, the imaging could help with treatments.Dr. Leo Hofstra from the department of cardiology at the University Hospital of Maastricht in the Netherlands and his colleagues discovered that by attaching a radioactive tracer to annexin A5 — a protein that binds to dying cells — they could image whether programmed cell death was occurring in heart failure patients.As reported in the April issue of The Journal of Nuclear Medicine, nine patients with advanced heart failure caused by dilated cardiomyopathy received Tc-annexin A5 intravenously. Six hours later, their hearts were imaged with a SPECT camera from Siemens. Of the nine patients, five showed an uptake of the protein radiotracer in the left ventricle. The remaining four patients did not show any uptake. The patients who did have the protein tracer showed worsening of left ventricular function at a one-year follow-up. By contrast, those who did not exhibit any uptake did show improvement of left ventricular function at the one-year follow-up. The researchers believe that their results indicate the annexin A5 imaging technique effectively detects programmed cell death in heart failure patients. They hope that this imaging technology can help to predict the course of heart failure in patients and to evaluate new treatment strategies.