Correspondence Letter by Schuster and Nagel Regarding Article, “Predicting Benefit From Revascularization in Patients With Ischemic Heart Failure: Imaging of

We read with interest the clinician update by Buckley and Di Carli1 that reviews the indications, accuracy, and clinical utility of the available noninvasive imaging techniques to guide the manage-ment of patients with ischemic heart failure. We completely agree that there is evidence to suggest that patients with hibernating myocardium benefit most from revascularization, whereas medical therapy is associated with an adverse prognosis and, thus, noninvasive testing should guide optimal management in these patients.2 Although the authors elegantly describe these modalities and their ability to assess myocardial hibernation and ischemia, their statement that it was now evident that, among other factors, the presence and magnitude of stress-induced ischemia can affect the outcome of the patient seems logical, but it raises an interesting question. Is there evidence to suggest that ischemia should be measured in addition t