Table 2.

Clinical value of myocardial blood flow reserve

No known CAD

High negative predictive value in combination with normal perfusion

Confirm an abnormality is CAD

Predict more severe disease: e.g., 1-vessel abnormal perfusion, 2-3-vessel abnormal MBFR

Confirm single vessel disease: 1 vessel abnormal perfusion, 1 vessel abnormal MBFR Normal perfusion, abnormal MBFR:  identify balanced CAD, microvascular disease

Identify non-responder: all patients

Known CAD

Often abnormal after CABG, CAD history, myocardial infarction

Cardiomyopathy less useful but if normal, helps exclude CAD

Renal failure patients generally abnormal

Post PCI may be abnormal, but most useful if pre-PCI data available

Identify non-responder: all patients