Key result
PET myocardial flow reserve and pressure-derived FFR are not interchangeable for evaluating coronary physiology.
Why the study?
Both PET-derived MFR and pressure-derived physiological indices like FFR evaluate coronary physiology, but they are not interchangeable due to certain discrepancies.
Systematic Review
PET-derived myocardial flow reserve and pressure-derived fractional flow reserve have only a modest correlation because MFR reflects both epicardial and microvascular disease, whereas FFR is a lesion-specific parameter.
Avoid equating PET MFR with FFR for coronary assessment; confirms modest correlation reflecting epicardial versus microvascular scopes.
Positron emission tomography (PET) permits the noninvasive quantification of myocardial blood flow (MBF). Myocardial flow reserve (MFR), calculated by dividing stress MBF by rest MBF is a reliable index for the functional information of coronary artery disease. A pressure-derived physiological index, such as fractional flow reserve (FFR) is also an important measurement. Both MFR and FFR values are used to evaluate coronary physiology; however, but they are not interchangeable because each test has certain discrepancies. In this systematic review, we provide an overview of coronary physiology with PET compared to pressure-derived physiological indices.
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Manabe et al. (2021) conducted a systematic review in Coronary artery disease. Myocardial flow reserve (MFR) by PET vs. Pressure-derived physiological indices (e.g., FFR) was evaluated. Myocardial flow reserve by PET and pressure-derived fractional flow reserve are both used to evaluate coronary physiology but are not interchangeable due to certain discrepancies.
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