Coronary artery disease detection - limitations of stress testing in left ventricular dysfunction

Table 2 Key advantages and limitations of various imaging modalities in detection of coronary artery disease in patients with left ventricular dysfunction

Modality	Advantages	Limitations
SPECT	Wide availability	Radiation
		May miss left main and triple vessel disease
DSE	Wide availability	Inter-observer variability
	Evaluates valves and pericardium	Nonspecific response to inotrope in LVD
PET	Viability evaluation	Radiation
	Quantifies myocardial blood flow
CCT	Anatomic information like invasive angiogram	Radiation
		Iodinated contrast in renal dysfunction
CMR	Evaluates valves and pericardium Viability evaluation	Gadolinium in renal dysfunction
	Determine etiology of DCM

DSE: Dobutamine stress echocardiography; SPECT: Single photon emission computerized tomography; PET: Positron emission tomography; CCT: Coronary computerized tomography; CMR: Cardiac magnetic resonance imaging; LVD: Left ventricular systolic dysfunction.