PET-based assessment of coronary microvascular dysfunction and its relation to plaque burden and vascular remodeling: integration with microvascular resistance reserve.
Eur J Nucl Med Mol ImagingJul 6, 2026 (epub)
Yipu Ding, Roel Hoek, Putri Annisa Kamila et al.
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In 30 seconds
This controlled clinical trial analyzed the relationship between coronary microvascular dysfunction (CMD), plaque burden, and vascular remodeling in symptomatic patients with suspected stable coronary artery disease (CAD). Using PET imaging, the study found that CMD vessels exhibited the largest lumen volume and area, with noncalcified plaque burden negatively impacting microvascular function (B = -0.12, P = 0.006).
Key findings
- Diameter stenosis and plaque burden increased from non-ischemic to CMD to epicardial flow-limiting vessels (all P < 0.05).
- CMD vessels had the largest lumen volume of 583.75 mm³ and lumen area of 4.63 mm² (both P < 0.05).
- Noncalcified plaque burden was associated with worse microvascular function (B = -0.12, P = 0.006).
- In CMD vessels, remodeling index was positively associated with higher microvascular resistance reserve (B = 0.10, P < 0.001).
Why it matters
Understanding the relationship between CMD and plaque characteristics can help clinicians better assess myocardial ischemia in patients with non-obstructive CAD, potentially guiding management strategies.