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Review
. 2023 Feb;30(1):227-238.
doi: 10.1007/s12350-022-03066-6. Epub 2022 Aug 2.

Strengths and weaknesses of alternative noninvasive imaging approaches for microvascular ischemia

Isabella Leo  1   2 , Eleni Nakou  1 , Jessica Artico  3   4 , Emmanouil Androulakis  1 , Joyce Wong  1 , James C Moon  3   4 , Ciro Indolfi  2   5 , Chiara Bucciarelli-Ducci  6   7
Affiliations
Review

Strengths and weaknesses of alternative noninvasive imaging approaches for microvascular ischemia

Isabella Leo et al. J Nucl Cardiol. 2023 Feb.

Abstract

Structural and functional abnormalities of coronary microvasculature are highly prevalent in several clinical settings and often associated with worse clinical outcomes. Therefore, there is a growing interest in the detection and treatment of this, often overlooked, disease. Coronary angiography allows the assessment of the Coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR). However, the measurement of these parameters is not always feasible because of limited technical availability and the need for a cardiac catheterization with a small but real risk of potential complications. Recent advances in non-invasive imaging techniques allow the assessment of coronary microvascular function with good accuracy and reproducibility. The objective of this review is to discuss the strengths and weaknesses of alternative non-invasive approaches used in the diagnosis of coronary microvascular dysfunction (CMD), highlighting the most recent advances for each imaging modality.

Keywords: cardiac magnetic resonance cardiac computed tomography; cardiovascular imaging; echocardiography; microvascular coronary dysfunction.

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