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Funding Acknowledgements Type of funding sources: None. Background. In recent years a group of patients with acute myocardial infarction without obstructive coronary artery disease (MINOCA) is of interest. In this group of patients, there is a lack of information related to myocardial perfusion, blood flow and reserve, which could be important in term of risk and prognosis assessment. Purpose. To assess the visual and quantitative MPS SPECT parameters in MINOCA patients compared to cardiac magnetic resonance (CMR) data. Methods.  In the period from 2017 to 2018 were examined 18 (8 male, mean 62.9 ± 10.7years) consecutive patients with acute myocardial infarction without obstructive coronary artery disease (MINOCA). Within 7-10 days after admission to the hospital and one year later all patients underwent SPECT myocardial perfusion scintigraphy (MPS) with the assessment of standard indices (SSS, SRS, SDS) and quantitative parameters: rest MBF (rMBF), stress MBF (sMBF) and CFR (on CZT gamma-camera). Also, all patients underwent CMR. Based on CMR data all patient were divided into two groups: 1) patients with non-ischemic type of injury and 2) patients with ischemic type of injury. Results. We found out significant correlation between regional quantitative SPECT indices and transmural extent of myocardial infarction evaluated by CMR: r=–0.4 for sMBF; r=–0.35 for CFR (p &amp;lt; 0.05). In the first hospitalization this groups of patient didn`t have of any differences, according visual and quantitative data by SPECT. However, in one year, visual analysis showed that SSS and SDS were significantly (p &amp;lt; 0.001) lower in patient with ischemic type of injury by CMR data: 2 (2; 3) vs 5.5 (4; 9) and 2 (1; 3) vs 4.5 (2; 5), respectively. According to the quantitative MPS data analysis, global and CFR values were significantly lower in patients with non-ischemic type of injury 1.30 (1.14; 1.75) vs 1.71 (1.34; 1.81). Conclusion. The analysis of quantitative MPS SPECT parameters showed that such approach allows identifying MBF and CFR disturbances. These results showed that MINOCA patients are heterogeneous group and require more strong investigation, observation and treatment.

Evaluation of visual and quantitative parameters of MPS SPECT in MINOCA patients in one year after acute coronary syndrome: comparison with CMR