Assessment of coronary flow reserve in nuclear cardiology

The coronary flow reserve is a quantitative parameter defined by the ratio maximal myocardial blood flow to rest myocardial blood flow, which allows to give functional information on the whole coronary arterial tree, integrating both epicardial arteries and microcirculatory. The coronary flow reserve is a powerful tool to guide therapy and to assess prognosis. Exploratory tools, initially limited to experimental invasive techniques, have evolved over the last 10 years, allowing to envisage its use in daily clinical practice. This article reviews the pathophysiology of the coronary flow reserve and the various invasive and non-invasive exploration tools available to practitioners, integrating them into clinical practice.