This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Samady, H. Articles by Barringhaus, K. G. Search for Related Content PubMed PubMed Citation Articles by Samady, H. Articles by Barringhaus, K. G.

Fractional Flow Reserve of Infarct-Related Arteries Identifies Reversible Defects on Noninvasive Myocardial Perfusion Imaging Early After Myocardial Infarction

Habib Samady, MD, FACC ^{_* , _*} , Wolfgang Lepper, MD, Eric R. Powers, MD, FACC, Kevin Wei, MD, FACC^{||, 1} , Michael Ragosta, MD, FACC _^* , Gregory G. Bishop, MD, Ian J. Sarembock, MD, FACC, Lawrence Gimple, MD, FACC, Denny D. Watson, PhD, George A. Beller, MD, MACC and Kurt G. Barringhaus, MD^¶

^_* Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
University Hospital RWTH Aachen, Aachen, Germany
Cardiovascular Division, University of Virginia School of Medicine, Charlottesville, Virginia
Department of Radiology, University of Virginia School of Medicine, Charlottesville, Virginia
^|| Oregon Health and Science University, Portland, Oregon
^¶ Cardiovascular Division, University of Massachusetts Medical School, Worcester, Massachusetts

View larger version (75K): [in a new window]   Figure 1 (A) Baseline rest and dipyridamole (DP)-stress vertical long axis single-photon emission computed tomography (SPECT) images and 10-week follow-up rest images are shown from a patient with anterior myocardial infarction who received thrombolytic therapy. When DP stress is paired with initial rest images there is a fixed perfusion defect in the anteroapical wall. When DP stress in paired with the delayed rest images, SPECT is reclassified as reversible. (B) Rest and post-DP stress myocardial contrast echocardiography images from the apical four-chamber view of the same patient demonstrate an apical-lateral perfusion defect during DP that was not present at rest, indicating reversibility. (C) Angiogram of the patient showing an 84% lesion in the left anterior descending coronary artery. (D) Fractional flow reserve (FFR) tracings showing an FFR of 0.48. QCA = quantitative coronary angiography.

View larger version (21K): [in a new window]   Figure 2 Concordance between FFR and SPECT (DP-stress paired with late rest imaging). Abbreviations as in Figure 1.

View larger version (24K): [in a new window]   Figure 3 Concordance between FFR and MCE. Abbreviations as in Figure 1.

View larger version (26K): [in a new window]   Figure 4 Concordance between FFR and combined noninvasive imaging. Abbreviations as in Figure 1.

View larger version (13K): [in a new window]   Figure 5 Sensitivity and specificity curves of fractional flow reserve for detecting reversibility of combined noninvasive testing.