Positron Emission Tomography imaging in coronary microvascular disease

There is growing evidence of the presence and relevance of coronary microvascular dysfunction (CMD) in many clinical conditions. In some instances these abnormalities represent important markers of risk and may contribute to the pathogenesis of myocardial ischemia, progressive cardiac dysfunction and heart failure. These recent evidences have justified the definition of "coronary microvascular diseases" for those conditions where CMD is predominant. Abnormalities in the function and structure of the coronary microcirculation occur in patients without obstructive epicardial coronary artery disease (CAD) but with cardiovascular risk factors (hypertension, dyslipidemia or diabetes), in the context of cardiomyopathies or in patients with CAD even in territories not subtended by stenotic arteries. In all these conditions CMD is also becoming a new potential therapeutic target.