3D PET Myocardial Blood Flow and Rb82 Infusion Profiles

As perfusion metrics in the healthy volunteers, patients with risk factors and/or coronary artery disease and in tissue with transmural myocardial infarctions has been well defined AND same day test-retest variability minutes apart using a bolus infusion is ±10%, the investigators shall test 3 hypotheses. The first hypothesis is repeated same day test-retest coefficient of variation (COV) of whole heart rMBF and sMBF acquired using a bolus infusion profile (50 mls/min) on a modern 3D PET scanner falls within ± 10%. The second hypothesis is repeated same day test-retest COV of whole heart rMBF and sMBF acquired using a slow infusion activity profile (20 mls/min) on a modern 3D PET scanner falls within ± 10%. The third hypothesis is COV of whole heart rMBF and sMBF between bolus and slow activity profiles is ± 10% where the bolus is considered the standard on a modern 3D PET scanner.

The investigators will test the different activity profiles on 3 distinct populations:

• Healthy volunteers
• Clinical volunteers with risk factors and/or CAD
• Volunteers with clinical infarcts.

Inclusion criteria

Normal Volunteers

• Adults ≥18 and <40 years old able to give informed consent.
• Ability to abstain from caffeine for 48 hours

The "clinical" population

• Adults ≥18 years old able to give informed consent.
• Any cardiac risk factor including hypertension, hyperlipidemia, diabetes mellitus or tobacco use OR
• CAD defined by with history of PCI or CABG, Coronary Ca score>400, or dense coronary calcifications noted on chest CT
• Ability to abstain from caffeine for 48 hours

The "infarct" population

• Adults ≥18 years old able to give informed consent.
• Prior cardiac PET scan demonstrating a fixed defect ≥ 15% of the LV myocardium with relative uptake ≤60% maximum uptake.
• In addition, to the perfusion defect, each volunteer requires either:

• FDG PET or MRI viability studies confirming infarct OR
• akinesis and wall thinning on ECHO within the same territory as the PET defect in addition to Q-waves on ECG
• Ability to abstain from caffeine for 48 hours

Exclusion criteria

Normal Volunteers

• Any chronic cardiac disease or condition (e.g., hypertension, hyperlipidemia)
• Any chronic systemic disease or condition (e.g., diabetes, systemic lupus, rheumatoid arthritis)
• Tobacco use
• Family history in a first degree relative with clinical CAD (h/o PCI, MI or CABG) in men <55 or women <65
• Severe claustrophobia
• Positive urine pregnancy test
• Inability to give informed consent
• BMI ≥ 30 or BMI>25 and <30 provided waist to hip ratio >0.80 in women or 0.90 in men.

The "clinical" and "infarct" populations

• Severe claustrophobia
• Hemodynamic instability or unstable symptoms
• Positive urine pregnancy test
• Inability to give informed consent