Perfusion and function assessment by nuclear cardiology techniques.

This review focuses on the currently available nuclear cardiology techniques for assessing simultaneously myocardial perfusion and left-ventricular function information. The ability to obtain both types of information in the same patient has been considered impractical because of logistics restraints. New software development now permits ventricular function and myocardial perfusion information to be obtained by electrocardiogram-gated images of the perfused myocardium. These images permit analysis of wall motion as well as measurements of ejection fraction. New advances in the past decade such as the development of technetium-labeled perfusion tracers and portable compact multicrystal gamma cameras have provided the ability to perform single-photon emission computed tomography (SPECT) imaging and first-pass radionuclide angiography during a single exercise test. This particular technique offers the advantage of performing all three tests--exercise treadmill, radionuclide angiocardiography, and myocardial perfusion imaging--during a single exercise session. Preliminary data regarding the current clinical role of these studies in the diagnosis, prognosis, and assessment of viability in patients with coronary artery disease also is addressed.