Fatty acid metabolic imaging with 123I-BMIPP for the diagnosis of coronary artery disease: application to patients with diabetes mellitus and hyperlipidaemia.
The aim of this study was to assess the relation of plasma substrate concentration to 123I-beta-methyliodophenyl-pentadecanoic acid (123I-BMIPP) kinetics in the myocardium and to test the application of 123I-BMIPP imaging to patients with diabetes mellitus (DM) and/or hyperlipidemia (HL). 123I-BMIPP imaging was performed on 78 patients with suspected coronary artery disease, 22 with HL, 11 with DM, 12 with HL and DM, and 33 with neither HL or DM. Significant coronary stenosis (defined as > or = 50% of luminal diameter) was documented in 49 patients. After an overnight fast, blood samples were drawn for blood glucose, insulin, cholesterol, triglycerides and free fatty acid levels. Then, 148 MBq 123I-BMIPP was injected intravenously and flushed rapidly with saline. Data were obtained for 60s in a standard anterior projection in list mode, at a rate of 1 frame per second. Myocardial single photon emission tomographic (SPET) images were obtained 20 min and 4 h post-injection. The myocardial uptake of 123I-BMIPP was calculated using the Ishii-MacIntyre method. Regional accumulation of 123I-BMIPP was scored semi-quantitatively from 0 (normal) to 4 (no activity), and the sum of regional scores in each patient was defined as the total defect score (TDS). Myocardial uptake and clearance of 123I-BMIPP had no relation to the levels of blood glucose, insulin, cholesterol, triglycerides or free fatty acids. Myocardial uptake and clearance of 123I-BMIPP, TDS and the sensitivity of detecting significant coronary stenosis were not significantly different between the four groups of patients. We conclude that 123I-BMIPP can be used to detect impaired fatty acid metabolism in patients with diabetes mellitus and/or hyperlipidaemia.
Takeishi
Y
Y
First Department of Internal Medicine, Yamagata University School of Medicine, Japan.
Atsumi
H
H
Fujiwara
S
S
Takahashi
K
K
Tomoike
H
H
D001693:Biological Transport, Active; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging* / Q000378:metabolism*; D003925:Diabetic Angiopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism; D005227:Fatty Acids / Q000378:metabolism* / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism*; D007457:Iodine Radioisotopes / Q000493:pharmacokinetics; D007462:Iodobenzenes / Q000493:pharmacokinetics; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D014018:Tissue Distribution; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000706:statistics & numerical data
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid; D017256:Technetium Tc 99m Sestamibi