title: Functional relevance of coronary artery disease by cardiac magnetic resonance and cardiac computed tomography: myocardial perfusion and fractional flow reserve.
abstract: Coronary artery disease (CAD) is one of the leading causes of morbidity and mortality and it is responsible for an increasing resource burden. The identification of patients at high risk for adverse events is crucial to select those who will receive the greatest benefit from revascularization. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography, but the diagnostic yield of elective invasive coronary angiography remains unfortunately low. Stress myocardial perfusion imaging by cardiac magnetic resonance (stress-CMR) has emerged as an accurate technique for diagnosis and prognostic stratification of the patients with known or suspected CAD thanks to high spatial and temporal resolution, absence of ionizing radiation, and the multiparametric value including the assessment of cardiac anatomy, function, and viability. On the other side, cardiac computed tomography (CCT) has emerged as unique technique providing coronary arteries anatomy and more recently, due to the introduction of stress-CCT and noninvasive fractional flow reserve (FFR-CT), functional relevance of CAD in a single shot scan. The current review evaluates the technical aspects and clinical experience of stress-CMR and CCT in the evaluation of functional relevance of CAD discussing the strength and weakness of each approach.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Gianluca
authors.identifier: 0000-0002-1339-6679
authors.initials: G
authors.lastname: Pontone
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy ; Department of Cardiovascular Sciences and Community Health, University of Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Andreini
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Andrea
authors.identifier: 0000-0002-8261-4529
authors.initials: A
authors.lastname: Baggiano
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: Bertella
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Saima
authors.initials: S
authors.lastname: Mushtaq
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Edoardo
authors.identifier: 0000-0003-1443-5788
authors.initials: E
authors.lastname: Conte
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Virginia
authors.identifier: 0000-0003-3509-8178
authors.initials: V
authors.lastname: Beltrama
authors.affiliation: Ospedali Riuniti, Department of Cardiology, University of Foggia, Italy.
authors.forename: Andrea Igoren
authors.initials: AI
authors.lastname: Guaricci
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138 Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000818:Animals; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D009206:Myocardium; D014057:Tomography, X-Ray Computed / Q000379:methods*