First-pass radionuclide ventriculography followed by myocardial SPECT with technetium-99m methoxy isobutyl isonitrile (Tc-99m MIBI) was performed on 12 patients with suspected coronary artery disease at rest and during exercise. Left ventricular wall motion and myocardial perfusion were assessed simultaneously and compared on a segment-by-segment basis. Segmental agreement between Tc-99m MIBI and Tl-201 with regard to the presence of perfusion defects was 95% (57/60) at rest and 93% (37/40) during exercise. With respect to the assessment of myocardial ischemia and/or infarction, abnormalities in regional wall motion agreed with the presence of myocardial perfusion defects in 18 out of 21 segments (86%). Simultaneous evaluation of regional wall motion and myocardial perfusion by Tc-99m MIBI may provide useful information for the assessment of myocardial ischemia.
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