Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology The Effect of Coronary Revascularization on Regional Myocardial Blood Flow as Assessed by Stress Positron Emission Tomography Robert M. Bober MD 1, 2, Caleb D. Thompson MD 1, Daniel P. Morin MD MPH 1, 2 1 John Ochsner Heart and Vascular Institute, Ochsner Medical Center, New Orleans, LA 2 Ochsner Clinical School, Queensland University School of Medicine, New Orleans, LA Copyright American Society of Nuclear Cardiology

BACKGROUND 1- In patients with stable CAD, the goal of myocardial revascularization is to improve myocardial blood flow (MBF). 2- % stenosis on coronary angiography is often the main factor when deciding to perform revascularization but does not reliably relate to MBF. 3- It is assumed that regional MBF improves after revascularization however, there is a lack of data supporting this assumption. 4- Changes in regional MBF can be measured accurately using Positron Emission Tomography. Copyright American Society of Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology

METHODS A.Study type: Retrospective B.Study subjects: Patients who underwent revascularization triggered by PET stress testing that subsequently had a second PET stress test. C.Study endpoints: A.Changes in regional absolute hyperemic myocardial blood flow and Coronary Flow Reserve (CFR) Copyright American Society of Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology

RESULTS Copyright American Society of Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology

RESULTS Copyright American Society of Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology

CONCLUSIONS 1- When a stress-induced perfusion defect exists on PET, revascularization improves sMBF and CFR in that region. 2- When an area of myocardium shows no baseline defect, sMBF and CFR show no net change whether or not intervention is performed in that area. 3-PET stress imaging may be used to identify areas of myocardium that could benefit from revascularization, and also areas in which intervention is unlikely to yield improvement in myocardial blood flow. 4- This is the first study to report changes in regional myocardial blood flow following coronary revascularization. Copyright American Society of Nuclear Cardiology Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology