Absence of myocardial 123I-BMIPP uptake in the presence of a normal coronary angiogram and normokinetics on a left ventriculogram.
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.
Inoue
F
F
First Department of Internal Medicine, Nara Medical University, Japan.
Hashimoto
T
T
Nishida
Y
Y
Dohi
K
K
Matsushima
A
A
Sakakibara
H
H
Ishida
Y
Y
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
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid