In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

This content is currently on FREE ACCESS


Prognostic value of global stress myocardial blood flow in patients with suspected obstructive coronary artery disease

Session Poster session II

Speaker Esa Harjulahti

Congress : ICNC, Nuclear Cardiology & Cardiac CT 2019

  • Topic : imaging
  • Sub-topic : Positron Emission Tomography (PET)
  • Session type : Poster Session
  • FP Number : P309

Authors : E Harjulahti (Turku,FI), I Stenstrom (Turku,FI), T Maaniitty (Turku,FI), W Nammas (Turku,FI), M Maki (Turku,FI), A Saraste (Turku,FI), J Knuuti (Turku,FI)

E Harjulahti1 , I Stenstrom1 , T Maaniitty1 , W Nammas1 , M Maki1 , A Saraste2 , J Knuuti1 , 1Turku PET Centre - Turku - Finland , 2Turku University Hospital, Heart Center - Turku - Finland ,



We have previously demonstrated that reduced regional stress myocardial blood flow (MBF, < 2.3 ml/g/min) by 15O-water positron emission tomography (PET) perfusion imaging accurately detects obstructive coronary artery disease (CAD) and provides prognostic information. It has also been previously shown that reduced global perfusion defined as coronary flow reserve (CFR) of < 2.0 is a strong prognostic marker, but the prognostic value of global stress MBF by 15O-water PET is unknown.


We evaluated the prognostic value of reduced global stress MBF by 15O-water PET during adenosine stress in patients with suspected CAD.


Consecutive patients from 2006 to 2014 who had sequential coronary CT angiography (CTA) and 15O-water PET performed at our hospital for evaluation of suspected obstructive CAD were evaluated. PET perfusion imaging was performed only if obstructive CAD (= 50% stenosis) was suspected based on coronary CTA. All patients (n=512) who had 15O-water PET during adenosine stress performed were included in this study. Major adverse events (AE), including cardiovascular (CV) mortality, myocardial infarction (MI) and unstable angina pectoris (UAP) were recorded from hospital records during an average follow-up of 6.2 years. Prognostic value of reduced global stress MBF defined as < 2.0 ml/g/min  was evaluated by Kaplan-Meier analysis.


During mean follow-up of 6.2 years there were 43 events (7 CV deaths, 22 MIs and 14 UAPs) corresponding to an annual event rate of 1.4%. Out of 512 patients, 89 had reduced global stress MBF (< 2.0 ml/g/min). Out of 423 patients who had preserved global stress MBF (= 2.0 ml/g/min), 207 showed regional ischemia defined as stress MBF < 2.3 ml/g/min, whereas 216 had no regional ischemia. Patients with reduced global stress MBF had significantly higher annual AE rate than patients with normal global stress MBF (2.6% vs. 1.2%, p = 0.012). Regional ischemia in the presence of preserved global stress MBF was associated with an intermediate annual event rate of 1.6% (p = 0.007 vs. reduced global stress MBF). Patients having preserved global stress MBF without regional ischemia had the lowest event rate (0.7%, p = 0.007 vs. preserved global stress MBF with regional ischemia, or reduced global stress MBF). 


Globally reduced stress MBF by 15O-water perfusion PET is associated with increased risk of adverse events. Compared with regional ischemia, global MBF provides incremental prognostic information.

Based on your interests

Three reasons why you should become a member

Become a member now
  • 1Access your congress resources all year-round on the New ESC 365
  • 2Get a discount on your next congress registration
  • 3Continue your professional development with free access to educational tools
Become a member now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are