{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:59:30Z","timestamp":1790751570349,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T00:00:00Z","timestamp":1790640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Physio Funct Imaging"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with suspected coronary artery disease (CAD), diffusely impaired hyperaemic myocardial blood flow (MBF) may indicate a multivessel epicardial CAD but also impaired coronary microcirculation. We assessed whether relative hyperaemic MBF\u2014that is, the ratio of the lowest to the highest regional hyperaemic MBF\u2014predicts obstructive CAD in patients with diffusely impaired hyperaemic MBF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We studied 874 patients who underwent coronary computed tomography angiography and [\n                      <jats:sup>15<\/jats:sup>\n                      O]H\n                      <jats:sub>2<\/jats:sub>\n                      O myocardial perfusion imaging with positron emission tomography at Kuopio University Hospital, Finland, in 2017\u20132023. The final analyses included 64 patients who had diffusely impaired hyperaemic MBF and were subsequently referred to invasive coronary angiography (ICA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In ICA, 34\/64 (53%) patients had obstructive CAD. Compared to patients with non\u2010obstructive CAD, those with obstructive CAD had lower relative hyperaemic MBF: 66% (95% CI 62\u201369%) versus 52% (95% CI 47\u201357%), respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). When relative hyperaemic MBF was used to predict the presence of obstructive CAD in ICA, the receiver operating characteristic analysis showed an area under the curve of 0.778 (95% CI 0.666\u20130.891). In binary logistic regression analysis, relative hyperaemic MBF independently predicted obstructive CAD (OR\u2009=\u20090.92 [95% CI 0.86\u20130.97],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obstructive CAD is more likely in patients with lower relative hyperaemic MBF. Consequently, relative hyperaemic MBF may have clinical utility in patients with suspected CAD and diffusely impaired hyperaemic MBF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cpf.70096","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:23:24Z","timestamp":1790749404000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diffusely impaired myocardial perfusion in patients with suspected coronary artery disease: Clinical utility of relative perfusion"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6721-1166","authenticated-orcid":false,"given":"Niklas","family":"Vartiainen","sequence":"first","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2415-3979","authenticated-orcid":false,"given":"Antti\u2010Pekka E.","family":"Rissanen","sequence":"additional","affiliation":[{"name":"Helsinki Sports and Exercise Medicine Clinic (HULA), Foundation for Sports and Exercise Medicine Helsinki Finland"},{"name":"Sports and Exercise Medicine, Faculty of Medicine University of Helsinki Helsinki Finland"},{"name":"Department of Medicine Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7718-5144","authenticated-orcid":false,"given":"Suvi","family":"Hartikainen","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svantte","family":"Halttunen","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine North Karelia Central Hospital Joensuu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9590-0105","authenticated-orcid":false,"given":"Aleksi J.","family":"Leikas","sequence":"additional","affiliation":[{"name":"A.I. Virtanen Institute for Molecular Sciences University of Eastern Finland Kuopio Finland"},{"name":"Heart Center, Kuopio University Hospital Kuopio Finland"},{"name":"Gene Therapy Unit, Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1935-2635","authenticated-orcid":false,"given":"Elina","family":"Kariniemi","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Kuopio University Hospital Kuopio Finland"},{"name":"Department of Clinical Radiology Kuopio University Hospital Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Strengell","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Mikkeli Central Hospital Mikkeli Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paavo\u2010Ilari","family":"Kuikka","sequence":"additional","affiliation":[{"name":"Department of Clinical Physiology and Nuclear Medicine Mikkeli Central Hospital Mikkeli Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0847-107X","authenticated-orcid":false,"given":"Juha E. 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