PMC2734934_01
(a)-(e) PET imaging before (a)-(d) and after (e) 18 sessions of ultrasound-guided CSWT focused on the septal and inferior wall in this patient with chronic refractory angina and without a revascularization option. (a) Bulleye map of myocardial viability FDG PET at baseline, showing preserved viability (red). (b) Perfusion at rest as assessed with N-13-ammonia PET with quantitatively normal perfusion values. (c) Perfusion with N-13-ammonia under adenosine stress at baseline revealed severely reduced perfusion values in the anterior and anteroseptal wall, the apical half of the lateral wall and in the apex. (d) and (e) Blownup maps of stress perfusion at baseline (D=C) and followup (e) with improved stress perfusion in parts of the septum and the adjacent inferior wall.
CRM2009-639594.001.jpg
PMC2734934_01_CRM2009-639594.001.jpg
fig1
Areas of decreased stress perfusion were found predominantly in the apex and the anterior and inferior septal wall (Figures 1(c)  and 1(d)), while viability (Figure 1(a)) and perfusion at rest (Figure 1(b)) were preserved.  Repeated PET imaging showed a substantial improvement of myocardial stress perfusion predominantly in the septum and the adjacent posterior wall (Figures 1(d) and 1(e)).