Prognostic Information Available from Cardiac Perfusion and Functional Studies

• Number of reversible defects is an indicator of multivessel disease and predictor of future adverse cardiac events. Single reversible defect does not exclude multivessel disease, but more than one reversible defect predicts multivessel disease.
• Size and severity of reversible defects is an indicator of myocardium at risk and predictor of future adverse cardiac events.
• Extent of fixed defects is predictor of future adverse cardiac events.
• Abnormal lung accumulation of ²⁰¹Tl: > 50% lung-to-heart ratio on exercise and > 65% on dypiridamole stress is a marker for transient left ventricular dysfunction at exercise and correlates with multivessel disease and increased morbidity and mortality rates.
• Transient ischemic dilatation in the setting of coronary artery diseae indicates multivessel or left main disease and is predictor of future adverse cardiac events.
• Normal perfusion is associated with a less than 1% risk of adverse myocardial event per year.
• Nonfatal myocardial infarctions better predicted by reversible perfusion abnormalities than LVEF.
• LVEF < 45% or ESV > 70 cc associated with high mortality.
• LVEF > 45% or ESV < 70 cc associated with low mortality (< 1%/year) even in the presence of severe perfusion abnormalities.