Utility of iodine-123-BMIPP in the diagnosis and follow-up of vasospastic angina.
Myocardial damage caused by vasospastic angina (VSA) may be detected by [123I]BMIPP, a beta-methyl-branched fatty acid. We investigated whether BMIPP could be used in the diagnosis and follow-up of patients with VSA.


METHODS
Thirty-two patients with VSA were studied with resting BMIPP-SPECT in comparison to stress perfusion imaging with either 201Tl or 99mTc-MIBI. During coronary arteriography, spasm was induced by provocative testing with acetylcholine or ergonovine, and only total or subtotal occlusion was considered positive. Decreased BMIPP uptake was semiquantitatively evaluated segmentally aided by polar map display.


RESULTS
Reduced BMIPP uptake was observed in 25 of 32 patients (78%), with complete or partial agreement between the BMIPP abnormality and coronary territory seen in 23 patients (72%). In contrast, a perfusion abnormality was seen in only 10 patients (31%). In the repeat BMIPP study (n = 23) during the follow-up period (average 206 days), 11 of 14 patients who showed BMIPP improvement also had improved angina attacks. Conversely, two of nine patients with nonimproved BMIPP showed improved symptoms (p < 0.05).


CONCLUSIONS
BMIPP can detect myocardial injury associated with VSA and may be useful in monitoring response to treatment.
D000109:Acetylcholine; D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003652:Decanoic Acids; D004874:Ergonovine; D005227:Fatty Acids; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D017256:Technetium Tc 99m Sestamibi; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D003652:Decanoic Acids; D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid; D017256:Technetium Tc 99m Sestamibi; D000109:Acetylcholine; D004874:Ergonovine