Integrated approach to evaluating coronary artery disease and ischemic heart disease.

Integrated imaging, using multidetector computed tomography-based coronary computed tomography angiography and magnetic resonance imaging myocardial-viability maps, can help to noninvasively provide information about the morphologic and physiologic significance of obstructive and nonobstructive coronary lesions. Lesion characteristics and the presence or absence of collaterals beyond an occlusive coronary arterial lesion can be assessed in relation to the size and distribution of the resulting myocardial necrosis, thereby improving understanding of the association between atherosclerotic lesion development and subsequent myocardial damage. To this end, coregistered displays can be produced to permit establishment of the direct spatial relationship between a specific coronary artery system anatomy and specific myocardial regions of the left ventricle under consideration for treatment in an individual patient. Consequently, additional insights about the appropriateness of and/or approach to revascularization of specific myocardial regions can be provided.