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Coronary disease & ACSResearch article

Diffuse Perfusion Impairment Versus Global Myocardial Flow Reserve and Focal Perfusion Impairments in Patients Undergoing 82 Rb-PET Imaging

Circ Cardiovasc ImagingPublished

  • Consecutive patients undergoing positron emission tomography myocardial perfusion imaging
  • Multivariable Andersen-Gill Cox models with robust variance estimators
  • Restricted cubic splines
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Authors' conclusion

Diffuse impairments in myocardial perfusion are associated with poorer outcomes compared with focal impairments and are more informative than global MFR. Diffuse impairments may be more prognostic in patients with a preserved ejection fraction.

Study context

Population
Consecutive patients undergoing positron emission tomography myocardial perfusion imaging between 2019 and 2025patients, 1511 primary outcome events
Participants
8,500 patients
Comparison
Integrated myocardial flow reserve (MFR) vs global MFR
Outcome
Total burden of death, myocardial infarction, and heart failure hospitalization
Follow-up
Median 550 days (interquartile range, 203-1017 days)

Main finding

As reported in the abstract

diffusely impaired integrated MFR, HR per interquartile range (adjusted for both parameters)

2.02 [95% CI, 1.33-3.05]

global MFR, HR per interquartile range (adjusted for both parameters)

1.10 [95% CI, 0.82-1.47]

Diffuse perfusion impairment, HR per interquartile range

2.20 [95% CI, 1.72-2.82]

focal impairment, HR

1.25 [95% CI, 1.07-1.46]

Further findings

Diffusely impaired integrated MFR by left ventricular ejection fraction (interaction)

HR per interquartile range for greater diffuse impairment at ejection fraction 40%
1.43
HR per interquartile range for greater diffuse impairment at ejection fraction 50%
1.97
HR per interquartile range for greater diffuse impairment at ejection fraction 60%
2.49
HR per interquartile range for greater diffuse impairment at ejection fraction 70%
3.02
  • more prognostic in patients with a preserved left ventricular ejection fraction
  • P for interaction <0.001

Original publication

Diffuse Perfusion Impairment Versus Global Myocardial Flow Reserve and Focal Perfusion Impairments in Patients Undergoing 82 Rb-PET Imaging. Circ Cardiovasc Imaging. Published 1 May 2026. doi:10.1161/circimaging.125.019246
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Summarised from the published abstract; every number is checked against it