Clinical usefulness of iodine 123-labeled fatty acid imaging in patients with acute myocardial infarction.
BACKGROUND
Iodine 123-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid (BMIPP) has recently been developed, since normal myocardium metabolizes free fatty acids. This study investigated the clinical usefulness of BMIPP imaging in patients with acute myocardial infarction (MI), particularly in the detection of stunned myocardium in patients who underwent acute coronary revascularization.


METHODS
The subjects were 41 patients with acute MI who had undergone emergency coronary revascularization. Both BMIPP and thallium-201 images at rest were obtained during the subacute phase. The myocardial distribution of radiotracers was quantified by generating circumferential count-distribution profile analysis. Initial 201Tl imaging, delayed 201Tl imaging, and BMIPP imaging were performed, and the mean count densities in the infarct region (initial 201Tl images [TL1], delayed 201Tl images [TL2], and BMIPP images in the infarct region [BM], respectively) were obtained. The differences between mean count densities (TL1-BM: BM subtracted from TL1; TL2-BM: BM subtracted from TL2) were also calculated.


RESULTS
BM showed a higher correlation with wall motion data by echocardiography (WM) in the acute phase than other nuclear imaging tests, whereas TL2 showed the highest correlation with WM in the chronic phase. Acute to chronic WM improvement showed a good correlation with TL2-BM.


CONCLUSIONS
Single photon emission computed tomography imaging with BMIPP is a candidate for providing the "memory image" of ischemic damage, whereas TL2 reflects all viable tissue. The mismatch between the tracers can serve as an indicator of myocardial stunning.
First Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
H
H
Naruse
T
T
Arii
T
T
Kondo
M
M
Morita
M
M
Ohyanagi
T
T
Iwasaki
M
M
Fukuchi
D015906:Angioplasty, Balloon, Coronary; D005227:Fatty Acids; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D017682:Myocardial Stunning / Q000000981:diagnostic imaging*; D015607:Stents; D013382:Subtraction Technique; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid