Why Quantify Myocardial Perfusion?

Abstract

Myocardial blood flow (MBF) and coronary flow reserve (CFR), the ratio of MBF during hyperemia to basal MBF, are integrated measures of flow through both the large epicardial coronary arteries and the microcirculation. To date, positron emission tomography (PET) offers the most robust and best investigated method for quantifying MBF in vivo. The potential of MBF quantification to improve detection of patients with high-risk coronary artery disease (CAD) or to identify patients with variable degrees of microvascular or endothelial dysfunction are promising new clinical avenues which await further evaluation in larger prospective trials. The current experience with MBF quantification also demonstrates potential benefits in other groups of patients. The present article summarizes the published literature on MBF quantification in CAD and other cardiac conditions and outlines in which fields MBF quantification could offer important value to improve the treatment and prognosis of patients. Novel PET perfusion compounds that are not bound to an onsite cyclotron will improve availability of MBF quantification, promote its use in the clinical setting, and facilitate further studies to establish its clinical value.