Editorial - Non-Invasive Assessment of Myocardial Oxygenation with MRI

Cardiovascular disease (CVD) remains the number one cause of death in most western countries, and a major cause of hospital admissions. One major disorder of CVD is myocardial ischemia, resulting from upstream coronary artery stenosis or impaired microcirculation. The common clinical manifestations of myocardial ischemia are angina (stable and unstable), myocardial infarction (heart attack), heart failure, arrhythmia (irregular heart beat), and sudden death. The cause of myocardial ischemia is the lack of oxygen-rich blood supply to the myocardial tissue. Balance of myocardial oxygen supply and demand is essential for maintaining the integrity of myocardial metabolism and mechanical function. Strictly speaking, myocardial ischemia is defined by the imbalance of oxygen supply and demand in the myocardial tissue. The assessment of myocardial blood flow is not always adequate to determine whether the tissue is ischemic or not. Conversely, non-invasive assessment of this balance will have a significant clinical impact on the diagnosis and monitoring of cardiac patients with ischemia. Positron emission tomography (PET) has long been recognized as the gold standard for quantifying myocardial oxygenation in terms of myocardial oxygen consumption rate (MVO2) using a