The effect of coronary revascularization on regional myocardial blood flow as assessed by stress positron emission tomography

Abstract

When a stress-induced perfusion defect exists on PET, revascularization improves sMBF in that region. When there is no such defect, sMBF shows no net change, whether or not intervention is performed in that area. PET stress may be useful for identifying areas of myocardium that could benefit from revascularization, and also areas in which intervention is unlikely to yield improvement in myocardial blood flow.

Positron emission tomography absolute stress myocardial blood flow for risk stratification in nonischemic cardiomyopathy

“…Hyperemia was achieved with intravenous infusion of dipyridamole (142 mcg/kg/min). Attenuation correction, registration, image reconstruction of topographic views, arterial input selection, and computation of myocardial blood flow were performed, as previously reported 10,11 . SMBF was calculated using FDA‐approved software (HeartSee; University of Texas, Houston, TX).…”

Guiding coronary revascularization using PET stress myocardial perfusion imaging: The proof is in the pudding

“…[9][10][11][12] A quest for further refining the prognostic value of PET MPI has led to significant developments in the past decade in the area of assessment of rest and vasodilator stress MBF and thus calculation of regional MFR or coronary blood flow reserve (CFR) by PET MPI. 7,9,10 For the purpose of this editorial and to be consistent with the study reviewed, 13 we will use the term CFR although both CFR and MFR are used interchangeably in the literature.…”

“…22,23 These scenarios happen when focal stenosis is accompanied by preserved global MBF and CFR and vice versa when diffuse microvascular disease and abnormal CFR is accompanied by minimal abnormalities in FFR. [22][23][24] In this issue of the journal, Bober et al 13 sought to investigate changes in PET determined MBF, specifically stress MBF (sMBF), in a small group (n = 19) of patients undergoing pharmacologic rubidium-82 PET MPI pre (PET 1)-and post (PET 2)-percutaneous coronary intervention (PCI). The most common indications for the PET scans was chest pain and the population tested was intermediate to high-risk group overall.…”

Myocardial perfusion imaging prior to coronary revascularization: From risk stratification to procedure guidance

“…Bober et al 19 used positron emission tomography (PET) stress testing before and after coronary revascularization in a small series of 19 patients to show that myocardial regions with perfusion defects on initial imaging achieved a significant improvement in blood flow after revascularization. The study was not powered to detect differences in clinical outcomes, but the data suggest that MPI may be useful for determining if a myocardial region will or will not benefit from revascularization.…”