Enhanced Detection of Ischemic but Viable Myocardium by the Reinjection of Thallium after Stress-Redistribution Imaging

IN many patients with coronary artery disease, impaired left ventricular systolic function at rest is caused by regionally ischemic or "hibernating" myocardium rather than irreversibly damaged myocardium. 1 , 2 In such patients, left ventricular function will improve after revascularization. 3 4 5 6 However, the identification of patients with such potentially reversible left ventricular dysfunction has been difficult. Myocardial perfusion imaging with thallium-201 is a clinically important adjunct to exercise testing for the evaluation of patients with coronary artery disease. 7 , 8 Thallium imaging is of value in detecting viable myocardium when regions with perfusion defects during exercise (stress imaging) demonstrate "redistribution" of the isotope on images obtained . . .