title: Absence of myocardial 123I-BMIPP uptake in the presence of a normal coronary angiogram and normokinetics on a left ventriculogram.
abstract: We present the case of a 44-year-old man with abnormal myocardial fatty acid metabolism who exhibited no myocardial uptake of 123I-beta-methyl- iodophenyl pentadecanoic acid (123I-BMIPP). This patient presented to our hospital with an ECG abnormality detected during a medical check-up. He felt no chest discomfort, but a 12-lead ECG at rest showed flat T-waves in leads I, V5, and V6 with no marked ischemic changes during exercise. A left ventriculogram and coronary angiograms were normal. Thallium-201 single photon emission computed tomography imaging revealed a normal myocardial uptake, but 123I-BMIPP imaging showed no such uptake. However, 18F-labelled fluorodeoxyglucose positron emission tomography imaging after an overnight fast showed a marked increase in myocardial uptake. It appears that myocardial uptake of 123I-BMIPP was totally lacking and that energy production by the myocardium during fasting depended on the metabolism of glucose rather than of fatty acids.
authors.affiliation: First Department of Internal Medicine, Nara Medical University, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Inoue
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Nishida
authors.forename: K
authors.initials: K
authors.lastname: Dohi
authors.forename: A
authors.initials: A
authors.lastname: Matsushima
authors.forename: H
authors.initials: H
authors.lastname: Sakakibara
authors.forename: Y
authors.initials: Y
authors.lastname: Ishida
mesh_terms: D000328:Adult; D017023:Coronary Angiography; D004562:Electrocardiography; D005227:Fatty Acids / Q000378:metabolism*; D015637:Gated Blood-Pool Imaging; D006321:Heart / Q000000981:diagnostic imaging; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes / Q000378:metabolism*; D008297:Male; D009206:Myocardium / Q000378:metabolism*; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid