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Non-invasive Assessment of Microvascular and Endothelial Function
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Non-invasive measures of coronary microcirculation: Taking the long road to the clinic

Kieran S Chung1, Patricia K Nguyen2,3

  • 1Cardiology Section, Veterans Affairs Palo Alto Health Care Administration, Palo Alto, CA, USA.

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
|July 20, 2017
PubMed

Insights

Current non-invasive methods struggle to distinguish coronary microvascular disease (CMD) from epicardial stenosis. Evaluating intramyocardial blood volume aids CMD diagnosis alongside epicardial disease, improving patient management.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Vascular Biology

Background:

  • Coronary microvascular disease (CMD) is a significant cause of morbidity and mortality.
  • Current non-invasive diagnostic tools cannot reliably differentiate CMD from obstructive epicardial stenosis.

Discussion:

  • Intramyocardial blood volume assessment shows promise as a surrogate marker for microvascular health.
  • This method can diagnose CMD even when epicardial disease is present.
  • Limitations exist, particularly in early-stage CMD detection.

Key Insights:

  • Non-invasive strategies for CMD diagnosis remain a clinical challenge.
  • Intramyocardial blood volume evaluation offers a potential pathway for diagnosing concurrent CMD and epicardial stenosis.
  • Further research and technological development are crucial.

Outlook:

  • Advancing non-invasive diagnostic tools for CMD is essential for improved patient outcomes.
  • Investment in bedside technologies for CMD assessment is needed.
  • Enhanced diagnostic capabilities will facilitate more targeted therapeutic interventions.

Keywords:
Coronary microcirculationPET/CT imagingcoronary artery diseasecoronary blood flowdiagnostic and prognostic applicationmyocardial perfusion imaging: SPECT

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