Abstract
353 Objectives The present study aimed to determine the impact of lesion severity as assessed by the fractional flow reserve (FFR) on the transmural perfusion gradient (TPG) using H215O positron emission tomography (PET) imaging in patients evaluated for coronary artery disease (CAD). Methods Sixty-six patients evaluated for CAD were prospectively enrolled and underwent H215O PET imaging for quantification of TPG, which was defined as the ratio of subendocardial to supepicardial myocardial blood flow (MBF). Subsequently, invasive coronary angiography was performed and FFR obtained in all coronary arteries irrespective of the PET imaging results. Results Thirty (45%) patients were diagnosed with significant CAD (i.e. FFR ≤ 0.80), whereas on a per vessel analysis (n=198), 53 (27%) displayed a positive FFR. Transmural hyperemic MBF decreased significantly from 3.09 ± 1.16 to 1.67 ± 0.57 mL/min/g (p Conclusions Cardiac H215O PET imaging is able to detect transmural perfusion gradients and demonstrates a significantly lower hyperemic TPG in ischemic myocardium. However, the diagnostic accuracy of TPG seems to be limited compared to quantitative transmural perfusion assessment.
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