Positron emission tomography remains the unrivalled noninvasive imaging modality for absolute quantification of coronary microvascular resistance, while invasive methods are preferred in patients with epicardial obstructive disease.
Coronary microvascular dysfunction is a topic that has recently gained considerable interest in the medical community owing to the growing awareness that microvascular dysfunction occurs in a number of myocardial disease states and has important prognostic implications. With this growing awareness, comes the desire to accurately assess the functional capacity of the coronary microcirculation for diagnostic purposes as well as to monitor the effects of therapeutic interventions that are targeted at reversing the extent of coronary microvascular dysfunction. Measurements of coronary microvascular resistance play a pivotal role in achieving that goal and several invasive and noninvasive methods have been developed for its quantification. This review is intended to provide an update pertaining to the methodology of these different imaging techniques, including the discussion of their strengths and weaknesses.
Knaapen et al. (2009) conducted a review in Coronary microvascular dysfunction. Quantification methods for coronary microvascular resistance was evaluated. Positron emission tomography remains the unrivalled noninvasive imaging modality for absolute quantification of coronary microvascular resistance, while invasive methods are preferred in patients with epicardial obstructive disease.