Rest and exercise radionuclide angiography is a useful technique to study the cardiac adaptation during exercise in patients with coronary artery disease. Most patients with coronary artery disease have an abnormal EF response to exercise, although the magnitude of the change in EF may not correlate with the extent of coronary artery disease. The resting end-diastolic volume maybe the most important determinant of the presence and degree of left ventricular dilation during exercise in such patients. The exercise left ventricular EF improves after revascularization, but the EF response to exercise often remains abnormal. Evaluation of the regional and global left ventricular performance and the pressure-volume relationship during systole and diastole, as well as changes in these parameters after revascularization are possible. The exercise EF is also an important prognosticator in patients with known or suspected coronary artery disease.