ABSTRACT
INTRODUCTION Epicardial coronary artery patency has been the primary outcome measure of coronary angiography and intervention. Strategies to improve the effectiveness of both fibrinolytic and percutaneous interventional therapies have relied on these angiographic measures to assess treatment efficacy and outcome. Despite this reliance on epicardial patency there is significant variability in morbidity and mortality among patients with “full” restoration of coronary artery blood flow or TIMI grade 3 flow. The realization that restoration of epicardial flow is necessary but not sufficient has led to the evaluation of the myocardial microvasculature and reperfusion downstream as a more accurate predictor of clinical outcome and treatment efficacy.1,2 The goal of this chapter is to review the methods used to directly and indirectly evaluate myocardial perfusion.
