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[Assessment of postinfarction patients with nuclear techniques].

Residual myocardial ischemia and left ventricular systolic dysfunction are the major determinants of a patient's prognosis after myocardial infarction. Therefore, left ventricular function and residual ischemia should be evaluated in all patients before release. Coronary angiography should be performed in uncomplicated myocardial infarction patients with significant ischemia or left ventricular dysfunction. In these cases angiography must be performed to determine if coronary arteries are suitable for revascularization before performing a test of myocardial viability. Several radionuclide approaches are currently available for the clinical evaluation of patients after myocardial infarction. There is growing and consistent evidence that the scintigraphic approaches are the most sensitive technique to investigate the presence of ischemia or tissue viability and also to provide an accurate and reproducible evaluation of the left ventricular function. Most importantly, radionuclide evaluation in these patients provide valuable prognostic information. However, the number of patients with malignant arrhythmia's detected with routine evaluation is lower at this time. In several reports neuroadrenergic imaging evaluation with I-123-MIBG was predictive of sudden death. In consequence, it has been proposed that cardiac SPECT images with I-123-MIBG may provide important prognostic information in patients with uncomplicated myocardial infarction. Therefore it is not surprising that the incorporation of new radionuclide techniques may improve the evaluation of patients after myocardial infarction.