Matthieu Pelletier-Galarneau1,2, Vasken Dilsizian3. 1. Department of Medical Imaging, Institut de cardiologie de Montréal, Université de Montréal, Montréal, Québec, Canada. matthieu.pelletier-galarneau@icm-mhi.org. 2. Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. matthieu.pelletier-galarneau@icm-mhi.org. 3. Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
Abstract
PURPOSE OF REVIEW: The aim of this review is to provide an update on the use of positron emission tomography (PET) with myocardial blood flow (MBF) quantification for the diagnosis and management of patients with microvascular disease. RECENT FINDINGS: It is now recognized that a large proportion of patients with classical angina and non-obstructive epicardial disease are suffering from microvascular angina. Microvascular angina shares several key features with epicardial coronary disease, including many risk factors. Clinical criteria for the diagnosis of microvascular angina were recently proposed and PET imaging is called to play a central role in evaluation of these patients. Indeed, PET allows non-invasive measurements of MBF and flow reserve, which are altered in microvascular dysfunction. Furthermore, PET with flow quantification provides independent prognostic information and has the potential to monitor response to therapy in microvascular disease. PET with MBF quantification allows detection of microvascular dysfunction and plays a key role in the investigation of patients with suspected microvascular angina.
PURPOSE OF REVIEW: The aim of this review is to provide an update on the use of positron emission tomography (PET) with myocardial blood flow (MBF) quantification for the diagnosis and management of patients with microvascular disease. RECENT FINDINGS: It is now recognized that a large proportion of patients with classical angina and non-obstructive epicardial disease are suffering from microvascular angina. Microvascular angina shares several key features with epicardial coronary disease, including many risk factors. Clinical criteria for the diagnosis of microvascular angina were recently proposed and PET imaging is called to play a central role in evaluation of these patients. Indeed, PET allows non-invasive measurements of MBF and flow reserve, which are altered in microvascular dysfunction. Furthermore, PET with flow quantification provides independent prognostic information and has the potential to monitor response to therapy in microvascular disease. PET with MBF quantification allows detection of microvascular dysfunction and plays a key role in the investigation of patients with suspected microvascular angina.
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