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Figure 3 Signal Intensity-Time Curves and Stress Perfusion Images Demonstrating No Change in Hyperemic MBF in a Medically Managed Patient With a CTO

A patient with CTO of the middle portion of the right coronary artery. At baseline, hyperemic MBF, measured in ml/min/g, is greatly reduced in this midventricular inferior segment, subtended by the CTO, compared with a remote segment in the same slice (top left). At 6-month follow-up, hyperemic myocardial blood flow in the CTO segment remains unchanged and greatly reduced (bottom left). Magnetic resonance imaging on the right panels are midventricular slices taken at peak stress at the corresponding imaging time points, displaying perfusion deficits in the inferoseptal and inferior segments at baseline (top), which remain at 6-month follow-up (bottom). The borders of the inferoseptal segment are delineated by white arrows; the remote anterior segment is indicated by the black arrow. Abbreviations as in Figures 1 and 2.