Integrating Myocardial Blood Flow Measurements for Diagnosing Obstructive Epicardial Coronary Artery Disease and Coronary Microvascular Dysfunction (MVD)-Navigating Cardiac PET Imaging: Clinical Advantages, Barriers and Cutting-Edge Applications

Navigating Cardiac PET Imaging: Clinical Advantages, Barriers and Cutting-Edge Applications

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Video Summary

Dr. Krishna Patel, a cardiac imager, discusses the use of myocardial blood flow quantitation in stress-PET MPI to identify ischemic heart disease phenotypes, specifically focusing on obstructive coronary artery disease and coronary microvascular dysfunction. Traditionally, ischemic heart disease diagnostics have focused on obstructive disease; however, data shows many patients with angina lack obstructive coronary artery disease. These patients often experience adverse cardiac events due to non-obstructive atherosclerotic disease and coronary microvascular dysfunction. Non-invasive PET quantifies myocardial blood flow at rest and stress to assess overall coronary circulation, measuring parameters like myocardial flow reserve. The ability to differentiate these disease types is crucial as it impacts patient treatment strategies. Additionally, factors such as relative flow reserve and coronary calcium assessments on PET-CT help diagnose different phenotypes. Ultimately, the integration of stress-PET imaging and detailed flow assessments aids in identifying high-risk cardiac conditions accurately, even without significant obstructive findings.

Keywords

myocardial blood flow

stress-PET MPI

ischemic heart disease

coronary microvascular dysfunction

myocardial flow reserve

non-invasive PET