Modern scintigraphic methods for assessing myocardial blood flow and reserve

 Background. Today, myocardial perfusion scintigraphy is an informative and accessible method for evaluating ischemic changes in the heart. However, this method has limitations, which are more connected with a semiquantitative assessment of the study results. Currently, there is a class of specialized gamma cameras with detectors based on cadmium-zinc-telluride, which allow quantitative analysis of scintigraphic data on coronary hemodynamics, i.e. evaluate indicators of coronary blood flow and reserve.

The aim of the review was to present and summarize the information about the coronary circulation within physiological and pathological conditions, as well as the possibilities of modern radionuclide methods in assessing coronary blood flow and reserve.

Materials and methods. In the process of preparing the review article, “PubMed”, “Web of Science”, “ScienceDirect” and “Elibrary” scientific databases were used. Search requests included keywords such as: coronary artery disease, myocardial blood flow, coronary (myocardial) flow reserve, single-photon emission computed tomography, cadmium-zinc-telluride, positron emission tomography.

Results. The review includes information on the state and methods of regulating coronary hemodynamics under normal conditions and against the background of pathological changes. It also includes information about radionuclide methods for assessing coronary hemodynamics, which are of  historical importance, currently used and promising, as well as dynamic single-photon emission computed tomography.

Conclusion. The potential of dynamic single-photon emission computed tomography as a method for quantification of coronary blood flow and reserve is high. This technique can become a simple and affordable alternative to the existing methods for assessing coronary (myocardial) blood flow and reserve. This will increase the information content of radionuclide diagnostics in assessing the severity of coronary insufficiency for more accurate risk stratification and determination of appropriate treatment tactics for cardiac patients. 

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