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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Radionuclide myocardial perfusion imaging risk stratification