Impaired myocardial accumulation of 15-(p-iodophenyl)-9-(R,S)-methylpentadecanoic acid in a patient with hypertrophic cardiomyopathy and exercise-induced ischemia due to vasospasm.
We encountered a patient with hypertrophic cardiomyopathy complicated with exercise-induced myocardial ischemia. Exercise-stress 99mTc-tetrofosmin imaging demonstrated reversible ischemia in the lateral wall, whereas resting fatty acid imaging with a new beta-methyl branched fatty acid analogue, I-123-15-(p-iodophenyl)-9-(R,S)-methylpentadecanoic acid (123I-9-MPA), showed impaired uptake and accelerated washout kinetics in the inferoapical and posteroseptal walls but not in the ischemia-related region. These findings suggest that the metabolic derangement is closely related to cardiomyopathy per se rather than exercise-induced myocardial ischemia in this patient with hypertrophic cardiomyopathy and a spastic coronary lesion so that myocardial perfusion and 123I-9-MPA imagings may contribute to clarifying the etiological background of impaired myocardial fatty acid metabolism.
Doi
A
A
Second Department of Internal Medicine (Cardiology), Sapporo Medical University School of Medicine, Japan.
Nakata
T
T
Obara
F
F
Kyuma
M
M
Tsuchihashi
K
K
Fujimori
K
K
Shimamoto
K
K
D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging*; D003329:Coronary Vasospasm / Q000150:complications / Q000000981:diagnostic imaging*; D005080:Exercise Test; D005227:Fatty Acids / Q000493:pharmacokinetics; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D007462:Iodobenzenes / Q000493:pharmacokinetics; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D009206:Myocardium / Q000378:metabolism*; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics
D005227:Fatty Acids; D007462:Iodobenzenes; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C078700:technetium tc-99m tetrofosmin; C067799:4-iodophenyl-9-methylpentadecanoic acid