[Imaging methods in diagnosis of coronary heart disease]

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Physiology

Background:

• Coronary heart disease is a leading global cause of mortality.
• Coronary angiography visualizes stenosis but cannot assess myocardial microcirculation.
• Angiographic stenosis severity doesn't always correlate with myocardial ischemia extent.

Purpose of the Study:

• To highlight limitations of coronary angiography in assessing myocardial ischemia.
• To advocate for noninvasive techniques for physiological assessment of coronary stenoses.
• To explore the future clinical value of integrated cardiovascular assessment methods.

Main Methods:

• Review of current diagnostic limitations in coronary artery disease.
• Discussion of the need for noninvasive physiological assessment.
• Exploration of combined morphological, functional, and perfusion evaluation.

Main Results:

• Coronary angiography is insufficient for evaluating microcirculatory changes.
• Discrepancies exist between angiographic findings and actual myocardial ischemia.
• Noninvasive methods offer potential for comprehensive assessment.

Conclusions:

• Reliance solely on coronary angiography for stenosis severity is inadequate.
• Noninvasive physiological assessment is crucial for accurate ischemia evaluation.
• Future cardiovascular diagnostics require integrating morphology, function, and perfusion data.