Knott KD, Seraphim A, Augusto JB, et al. - Given macro- and microvascular coronary circulation is reflected by myocardial perfusion, and automated measurement clinically is enabled by recent quantitation developments employing cardiovascular magnetic resonance (CMR) perfusion, researchers investigated the prognostic significance of stress myocardial blood flow (MBF) and myocardial perfusion reserve (MPR, the ratio of stress to rest MBF). In this two-center study, patients having both suspected and known coronary artery disease referred clinically for perfusion evaluation were analyzed. The independent link of stress MBF and MPR with both mortality and major adverse cardiovascular events (MACE) was identified. The adjusted hazard ratio (HR) for death and MACE were estimated to be 1.93 and 2.14 respectively, for each 1ml/g/min reduction in stress MBF, even following adjustment for age and co-morbidity. The adjusted HR for mortality and MACE were estimated to be 2.45 and 1.74 respectively, for each 1 unit reduction in MPR. Overall, adverse cardiovascular outcomes in patients with known or suspected coronary artery disease can be strongly and independently predicted by decreased MBF and MPR measured automatically inline applying artificial intelligence quantification of CMR perfusion mapping.