Myocardial perfusion imaging in advanced coronary artery disease

Journal
European Journal of Clinical Investigation
ISSN
0014-2972
Date Issued
2025-03-18
Author(s)
Roel Hoek
Pepijn A. van Diemen
Yvemarie B. O. Somsen
Ruben W. de Winter
Ruurt A. Jukema
Jorge E. Dahdal
Pieter G. Raijmakers
Roel S. Driessen
Ibrahim Danad
Paul Knaapen
Type
journal-article
DOI
URL
Abstract
Myocardial perfusion imaging (MPI) is widely adapted as a noninvasive technique to assess the presence and extent of ischemia in patients with symptoms suggestive of obstructive coronary artery disease (CAD). However, as CAD advances, several factors can complicate the interpretation of MPI, subsequently impacting clinical decision‐making. This review focuses on the utility of MPI by means of cardiac magnetic resonance (CMR) imaging, single‐photon emission computed tomography (SPECT) and positron emission tomography (PET) in patients with advanced CAD—the latter characterized by documented CAD (i.e. prior myocardial infarction [MI] and/or percutaneous coronary intervention [PCI]), prior coronary artery bypass grafting (CABG) or the presence of a chronic total occlusion (CTO). It will discuss factors impacting the interpretation of MPI, the diagnostic performance for detecting obstructive CAD and coronary microvascular dysfunction (CMD), as well as the role of MPI in guiding revascularization.
Subjects
adult

; 

cardiovascular magnetic resonance

; 

chronic total occlusion

; 

clinical decision making

; 

controlled study

; 

coronary artery bypass graft

; 

coronary artery bypass surgery

; 

coronary artery disease

; 

diagnosis

; 

diagnostic test accuracy study

; 

female

; 

heart infarction

; 

human

; 

male

; 

maximal respiratory pressure

; 

myocardial perfusion imaging

; 

non invasive procedure

; 

obstructive coronary artery disease

; 

patient history of coronary artery bypass graft

; 

percutaneous coronary intervention

; 

positron emission tomography

; 

review

; 

single photon emission computed tomography

; 

therapy

; 

cardiac magnetic resonance imaging

; 

chronic total occlusion

; 

coronary artery bypass grafting

; 

coronary artery disease

; 

coronary microvascular dysfunction

; 

myocardial infarction

; 

myocardial perfusion imaging

; 

percutaneous coronary intervention

; 

positron emission tomography

; 

single-photon emission computed tomography