Table 1.

Three clinical scenarios of MVD and the suggested assessment modalities.

Clinical Scenario	Patophysiology	PET	CMR	CT
MVD without obstructive CAD or myocardial diseases	Cardiovascular risk factors, such as hypertension and diabetes, determine endothelial dysfunction and abnormal function of vascular smooth muscle cells.	The most tested in this setting with a prognostic role	Tested in this setting	Contemporary assessment of epicardial vessels and MVD
MVD in the presence of obstructive CAD	Stable CAD: atherosclerotic involvement of microcirculation and endothelial dysfunction. Acute coronary syndrome: microvascular obstruction due to edema, hemorrhage and inflammation.	Tested in this setting	Tested in this setting and useful for tissue characterization	Contemporary assessment of epicardial vessels and MVD
MVD in the presence of myocardial or severe valvular diseases	Structural alterations (i.e., hypertrophy or interstitial fibrosis) determine capillary rarefaction and increase arterial stiffness.	The most tested in this setting	Tested in this setting and useful for tissue characterization and valvular diseases estimation	Not tested and limited usefulness in this setting