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Radionuclide myocardial perfusion imaging risk stratification

Radionuclide myocardial perfusion imaging risk stratification
High risk
  • Severe LV dysfunction (EF <35%)
  • Stress-induced large perfusion defect (particularly if anterior)
  • Stress-induced multiple perfusion defects of moderate size (>10% total reversible myocardium)
  • Large fixed defect with LV dilation or increased lung uptake (thallium-201)
  • Stress-induced moderate perfusion defect with LV dilation or increased lung uptake (thallium-201)
Intermediate risk
  • Mild to moderate resting LV dysfunction (EF 35 to 49%)
  • Moderate stress-induced perfusion defect without LV dilation or increased lung uptake
Low risk
  • Normal LV systolic function
  • Normal or small myocardial perfusion defect at rest or with stress
LV: left ventricular; EF: ejection fraction.
Adapted from: Gibbons RJ, Chatterjee K, Daley J, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999; 33:2092.
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