Dynamic changes in cardiac fatty acid metabolism in the stunned human myocardium.
BACKGROUND
The chronological changes or mechanisms in cardiac fatty acid metabolism under clinical conditions of hypoxia and ischemia have not been fully elucidated. 123-15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) can be used with single photon emission computed tomography (SPECT) to evaluate myocardial fatty acid metabolism. We investigated chronological changes in energy metabolism in the stunned human myocardium by means of 123I-BMIPP myocardial SPECT.


RESULTS
We conducted 123I-BMIPP myocardial SPECT in 10 patients with stunned myocardium during the acute, subacute and chronic phases after onset. The left ventricle was divided into 9 regions on SPECT, and the degree of abnormalities in each region was scored in four grades from normal (0) to defect (4). We also examined wash-out rates on BMIPP images. The scores on early BMIPP images in the acute, subacute and chronic phases were 5.6 +/- 1.8, 13.4 +/- 3.5 and 2.5 +/- 1.1, respectively, and the score was highest in the subacute phase (p < 0.001). Similarly, scores on the late images were 2.3 +/- 1.7, 18.3 +/- 4.5 and 4.7 +/- 2.6, respectively, and highest in the subacute phase (p < 0.001). The wash-out rates (normal: 18.2 +/- 2.1%) in the acute, subacute and chronic phases were 12.1 +/- 4.8%, 44.9 +/- 10.0% and 23.1 +/- 4.6%, respectively, with the value being lowest during the acute phase (p < 0.05), and highest during the subacute phase (p < 0.001).


CONCLUSIONS
These results suggested that fatty acid metabolism in the stunned human myocardium changes dynamically over time.
Ito
K
K
Division of Cardiology, Murakami Memorial Hospital, Asahi University, Japan. kazuki@poppy.ocn.ne.jp
Sugihara
H
H
Kawasaki
T
T
Katoh
S
S
Azuma
A
A
Nakagawa
M
M
D000368:Aged; D004452:Echocardiography; D004734:Energy Metabolism; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D017682:Myocardial Stunning / Q000000981:diagnostic imaging / Q000378:metabolism*; D009206:Myocardium / Q000378:metabolism*; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C049338:iodofiltic acid; C078700:technetium tc-99m tetrofosmin