Early detection and management of coronary atherosclerosis by O-15 water PET

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Assessment of coronary atherosclerosis plays a major role for dearly detection and management of patients with coronary artery disease. Positron emission tomography (PET) using O-15 labeled water permits quantitative assessment of myocardial blood flow, and therefore, this is valuable means for measurement of myocardial flow reserve and coronary endothelial function noninvasively. In the study of patients suspected with coronary artery disease, myocardial flow reserve was reduced not only in the areas with coronary stenosis but also in the remote areas in the patients having coronary risk factors. Multivariate analysis indicated that smoking and diabetes were the only independent variables which reduced myocardial flow reserve. In addition, coronary endothelial dysfunction was identified in patients with young healthy smokers and remote stage of Kawasaki disease. Moreover, such coronary endothelial dysfunction was reversible after smoking cessation. These data indicate that O-15 labeled water PET is feasible for early detection and management of coronary atherosclerosis in clinical setting.