Quantitative CMR perfusion imaging identifies reduced flow reserve in microvascular coronary artery disease

Background Patients with angina without obstructive coronary artery disease are increasingly recognized and microvascular disease (MVD) is thought to play a significant role. An abnormal myocardial perfusion reserve (MPR) by positron emission tomography is predictive of increased cardiovascular events, particularly in women, diabetics, and those with metabolic syndrome. We hypothesized that MPR as measured by CMR would be reduced in patients with angina or anginal equivalent symptoms and nonobstructive CAD/normal coronaries compared with asymptomatic controls.