We studied left ventricular perfusion and motility in 37 patients with coronary artery disease and disturbances of parietal motility, aged 57 +/- 9 years old, before and after revascularization. Perfusion was assessed with dipyridamole-tc99m MIBI SPECT and motility was assessed with two dimensional echocardiography with amrinone. Myocardial segments were defined as normal, viable or necrotic in both studies. Eighteen subjects were subjected to angioplasty and 19 to coronary bypass surgery. Submitted SPECT and echocardiography were repeated 64 +/- 15 and 69 +/- 23 days after revascularization respectively. The concordance between SPECT and echocardiographic pre-revascularization diagnosis was 60.1% Eighty one percent of segments considered viable with SPECT and 71% thus considered with echocardiography improved after revascularization. Likewise, 50% of segments considered necrotic with SPECT and 68% of segment thus considered with echocardiography did not improve. It is concluded that although there is a good concordance between both methods, they have limitations on the study of myocardial viability and should be considered as second choice.