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Regression modeling strategies are increasingly used for the management of subjects with cardiovascular diseases as well as for decision-making of subjects without known disease but who are at risk of disease in the short- or long-term or during life span. Accurate individual risk assessment, taking in account clinical, laboratory, and imaging data is useful for choosing among prevention strategies and/or treatments. The value of nuclear cardiology techniques for risk stratification has been well documented. Many models have been proposed and are available for diagnostic and prognostic purposes and several statistical techniques are available for risk stratification. However, current approaches for prognostic modeling are not perfect and present limitations. This review analyzes some specific aspects related to prediction model development and validation.

Myocardial perfusion imaging is important for the management of patients with suspected or known coronary artery disease. Nuclear cardiology is the most widely used noninvasive approach for the assessment of myocardial perfusion. The available single-photon emission CT (SPECT) flow agents are characterized by a rapid myocardial extraction and by a cardiac uptake proportional to blood flow. In addition, different positron emission tomography (PET) tracers may be used for the absolute quantitative measurement of myocardial blood flow and coronary flow reserve. However, the available SPECT and PET tracers for myocardial perfusion imaging have some limitations that must be considered to maximize their clinical applications and there is still a well-recognized need for the development of new perfusion tracers with more ideal properties. This review illustrates the current status and the future perspectives of blood flow tracers for SPECT and PET myocardial perfusion imaging.

Left ventricular (LV) function is one of the most powerful predictors of prognosis in the setting of heart failure (HF) or following myocardial infarction. It is important to differentiate patients in whom LV dysfunction is caused by necrosis and scar tissue formation from those with LV dysfunction because of ischemia or hibernating, but viable myocardium. Previous studies showed that identification of the latter group of patients predicts substantial survival benefit, symptomatic improvement, and improved LV function with revascularization. On the other hand, more recent investigations, such as the Surgical Treatment for Ischemic Heart Failure (STICH) trial [3], did not find a significant interaction between myocardial-viability status and medical versus surgical treatment with respect to the rates of death from any cause or from cardiovascular causes or the rate of death or hospitalization for cardiovascular causes.