Long-Term Prognostic Value of 13N-Ammonia Myocardial Perfusion Positron Emission Tomography

Abstract

Objectives: The goal of this study was to assess the predictive value of myocardial perfusion imaging with ¹³N-ammonia positron emission tomography (PET) and coronary flow reserve (CFR) on long-term prognosis in patients with suspected myocardial ischemia. Background: No prognostic data exist on the predictive value of CFR and ¹³N-ammonia PET. Methods: Perfusion and CFR were assessed in 256 patients using ¹³N-ammonia PET, and follow-up was obtained in 245 (96%) patients. Sixteen early revascularized patients were excluded and 229 were assigned to normal versus abnormal perfusion or normal versus abnormal CFR (13N-ammonia PET and CFR are strong outcome predictors. CFR allows further risk stratification, suggesting a “warranty” period of 3 years if normal CFR is associated with normal perfusion. Conversely, in patients with abnormal perfusion, an impaired CFR has added value for predicting adverse outcomes.