[Coronary angiography: beyond coronary anatomy]

Area of Science:

• Cardiology
• Medical Imaging
• Physiology

Background:

• Technical advances allow restoration of epicardial coronary artery blood flow in most myocardial infarction patients.
• Improved myocardial perfusion does not always follow restored blood flow, increasing interest in perfusion assessment.
• Conventional coronary angiography is a widely used technique for evaluating coronary artery blood flow.

Purpose of the Study:

• To evaluate the additional information provided by conventional coronary angiography regarding myocardial perfusion.
• To review data on epicardial and microvascular blood flow assessment using coronary angiography.
• To discuss the prognostic significance of these blood flow parameters.

Main Methods:

• Review of existing data on coronary angiography.
• Analysis of semiquantitative and quantitative assessment of epicardial coronary artery blood flow.
• Evaluation of microvascular blood flow assessment using coronary angiography.

Main Results:

• Coronary angiography provides data on both epicardial and microvascular blood flow.
• Quantitative and semiquantitative assessments of epicardial flow are possible.
• Microvascular function can be inferred from angiographic findings.

Conclusions:

• Conventional coronary angiography offers valuable insights into myocardial perfusion beyond epicardial flow.
• Assessment of both epicardial and microvascular components is crucial for understanding post-myocardial infarction outcomes.
• Angiographic assessment of blood flow has significant prognostic implications.