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BACKGROUND: The purpose of the study was to investigate and assess patients with severe, coronarographically document-ed coronary artery disease (CAD), previous myocardial infarc-tion and left ventricular dysfunction, using radionuclide method for myocardial perfusion scintigraphy with 99mTc-MIBI and ni-trate administration for detection of viable myocardium. MATERIAL AND METHODS: We investigated 56 patients (37 male, 19 female, mean age 58 – 8 years) with CAD and previ-ous myocardial infarction, mean EF 38 % – 12; divided into 2 groups: Group I 28 patients, investigated at rest, i.v. inject-ed 370 MBq 99mTc-MIBI, scintigraphy performed at 30 min and 4th hour; Group II 28 patients, investigated at rest, i.v. inject-ed 370 MBq 99mTc-MIBI, scintigraphy performed at 30 min, im-mediately after that administration of 20 mg Isosorbitdinitrate Increased redistribution of 99mTc-MIBI under the action of nitrate administration a good tool for detection of myocardial vitality in patients with severe CA