We recruited 28 patients clinically diagnosed with homozygous familial hypercholesterolemia (HoFH) and subjected them to 2D-STI, gated transthoracic Doppler echocardiography (TTDE), and <sup>99</sup>Tc<sup>m</sup>-methoxyisobutylisonitrile myocardial perfusion imaging (<sup>99</sup>Tc<sup>m</sup>-MIBI MPI).