RECENT DEVELOPMENTS IN THE PROGNOSTIC USE OF MYOCARDIAL PERFUSION IMAGING

Stress myocardial perfusion imaging has become a mainstay in the nonin vasive assessment of patients with known or suspected coronary artery disease for several compelling reasons. Radionuclide myocardial perfus ion imaging can be performed using a variety of stressors, including e xercise, pharmacologic stress (including dipyridamole, adenosine, dobu tamine, and arbutamine), or a combination of exercise and pharmacologi c stress. The combination of exercise and pharmacologic stress allows an assessment of the patient's exercise tolerance, to be performed whi te adequately stressing him or her pharmacologically. Radiopharmaceuti cal choice has been expanded to include not only thallium-201 but also technetium-based imaging agents such as sestamibi and tetrofosmin. Th e use of technetium imaging agents has recently been enhanced by the a bility to assess ventricular function using gated single-photon emissi on computed tomography (SPECT) imaging techniques. Finally, the abilit y to provide prognostic information in the same patients has led to in cremental clinical use.