The added value of simultaneous myocardial perfusion and left ventricular function.

The focus of this review is the advantages of simultaneously assessing myocardial perfusion and left ventricular function. Nuclear cardiology imaging techniques as well as the development of technetium-labeled perfusion tracers now permit combined myocardial-perfusion and left-ventricular function studies at a single testing interval. Radionuclide angiography as well as electrocardiographic-gated images of the perfused myocardium are the two well-established techniques for that purpose with a single injection of a technetium-labeled perfusion tracer. Recent data have demonstrated the impact and clinical role of these studies, when combined, in the diagnosis as well as prognosis and risk stratification of patients with suspected or known coronary artery disease. The addition of functional information to perfusion data has shown to improve the detection of multivessel disease. Most recent data have also demonstrated the ability of these combined measurements to improve the prediction of hard events. It appears that the role of each of these tests may differ, depending on the patient population, particularly in relation to gender and type of stress test performed. Finally, a third area of potential application of these combined techniques would be in the assessment of myocardial viability using pharmacologic stress tests in combination with wall-motion analysis by gated images of the perfused myocardium.