Cardiac Imaging and Diagnostics
Open access
Peer reviewed
Abstract
Abstract
Abstract Background Coronary microvascular dysfunction (CMD) contributes to myocardial ischemia in patients with angina and non-obstructive coronary artery disease. Quantitative positron emission tomography (PET) allows noninvasive assessment of myocardial blood flow and identification of CMD. Objectives To investigate the association between PET-assessed coronary microvascular dysfunction (CMD), coronary plaque burden, and vascular remodeling, integrating microvascular resistance reserve (MRR). Methods This post hoc analysis of the PACIFIC-1 trial included coronary arteries from symptomatic patients with suspected stable CAD who underwent [ 15 O]water PET, coronary CT angiography (CTA), and invasive fractional flow reserve (FFR). Coronary arteries were categorized into three groups: non-ischemic vessels (normal FFR and hyperemic myocardial blood flow [hMBF], n = 352), CMD vessels (normal FFR but impaired hMBF, n = 88), and epicardial flow-limiting vessels (abnormal FFR, n = 159). MRR was calculated by integrating PET-derived coronary flow reserve with invasive FFR. AI-based CTA quantified plaque burden and remodeling. Results Diameter stenosis and plaque burden increased progressively from non-ischemic to CMD to epicardial flow-limiting vessels (all P < 0.05). CMD vessels demonstrated the largest lumen volume (583.75 mm 3 [IQR 337.02–754.30]) and lumen area (4.63 mm 2 [IQR 3.77–6.67]) among the three groups (both P < 0.05). In non-ischemic vessels, noncalcified plaque burden was associated with worse microvascular function detected by MRR (B = -0.12, 95%CI [-0.21, -0.04], P = 0.006). In CMD vessels, remodeling index was independently associated with higher MRR after adjustment (B = 0.10, 95%CI [0.05, 0.15], P < 0.001). Conclusions CMD is associated with an intermediate atherosclerotic burden and paradoxical lumen enlargement, representing a distinct functional-structural phenotype defined by PET-derived microvascular dysfunction and CT-based plaque characteristics. Clinical Trial Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01521468. Graphical Abstract Abbreviations: CMD, coronary microvascular dysfunction; FFR, fractional flow reserve; MBF, myocardial blood flow; MRR, microvascular resistance reserve; PET, positron emission tomography-computed tomography.
Direct answer
What can I do from this paper page?
Use this page to scan "PET-based assessment of coronary microvascular dysfunction and its relation to plaque burden and vascular remodeling: integration with microvascular resistance reserve" quickly: start with the summary and abstract, then check the authors, source, topics, and related papers. From here, open Scollr to follow Cardiac Imaging and Diagnostics research, save the paper, or map adjacent work.
Research areas
Follow related topics
Citation
BibTeX
@article{Ding2026based,
title = {PET-based assessment of coronary microvascular dysfunction and its relation to plaque burden and vascular remodeling: integration with microvascular resistance reserve},
author = {Yipu Ding and Roel Hoek and Putri Annisa Kamila and Ibrahim Danad and Nick S. Nurmohamed and Ruurt Jukema and Pieter G. Raijmakers and Roel S. Driessen and Pepijn A. van Diemen and Andrew D. Choi and Juhani Knuuti and Paul Knaapen and Hongbin Liu and Jeroen J. Bax and Alexander van Rosendael and on the behalf of the PACIFIC-1 Investigators. and Pepijn van Diemen and Ruurt Jukema and lilian meijboom and Antti Saraste},
journal = {European Journal of Nuclear Medicine and Molecular Imaging},
year = {2026},
doi = {10.1007/s00259-026-08054-3},
url = {https://doi.org/10.1007/s00259-026-08054-3}
}FAQ
Using this paper in a discovery workflow
How do I find related work for this paper?
Use the related papers and topic links on this page as starting points. In Scollr, you can also open the paper and build a literature map around its references, citing papers, and related work.
How can I keep up with new Cardiac Imaging and Diagnostics research papers?
Follow Cardiac Imaging and Diagnostics research in Scollr. New papers from the topic flow into a personalized feed, and you can save useful studies to revisit later.
Can I cite this paper from this page?
This page includes a static BibTeX block for PET-based assessment of coronary microvascular dysfunction and its relation to plaque burden and vascular remodeling: integration with microvascular resistance reserve. Always verify the DOI, source, and publication details against the publisher record before submitting a manuscript.
Follow this research in Scollr
Follow the topics and authors behind this paper, save useful studies, and build a literature map when you are ready to go deeper.
Get the app