Angiographic measurement of coronary blood flow reserve. Does it work?

T he study reported by Hess et all in this issue of Circulation presents a timely opportunity to discuss several issues that are directly relevant to use of angiographic methods for estimating myocardial perfusion. These issues are motivation for use of angiographic methods, limitations of the gold standard used, limitations of the angiographic method, limitations of the conceptual model used and importance of negative studies in this field.

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