Simultaneous Assessment of FFR and SPECT

Patients who are previously scheduled for diagnostic coronary angiography will be approached
for consent to be part of the study. If the patient is found to have one or two vessel
disease and it is planned by the interventional cardiologist that FFR will be used, then the
previously consented patient will be deemed appropriate for the study. The standard procedure
will be followed for FFR testing using regadenoson. The patient will then receive the
standard dose of Tc-99m sestamibi. The interventional cardiologist will proceed with
percutaneous coronary intervention (PCI) if appropriate. Patients will proceed to the cardiac
catheterization laboratory holding area post procedure. Patients will then be scheduled to be
taken to the nuclear cardiology laboratory one to three hours following the coronary
angiogram for standard SPECT acquisition. Patients will be monitored for 2-6 hours or
overnight as clinically indicated following diagnostic coronary angiography and PCI. Low dose
resting myocardial perfusion scanning may be performed the next day if stress myocardial
perfusion study was abnormal.

Inclusion Criteria:

Patients undergoing clinically-indicated FFR measurement (to determine the hemodynamic
significance of intermediate degrees of stenosis) for single or two -vessel epicardial
coronary disease during diagnostic coronary angiography for suspected coronary artery
disease.

Exclusion Criteria:

1. Patients with 3-vessel disease

2. Prior coronary artery bypass grafting

3. Patients with second or third- degree atrioventricular block, without a functioning
pacemaker

4. Patients who have ingested caffeine-containing products within the past 12 hours.