Assessment of fatty acid metabolism in taxan-induced myocardial damage with iodine-123 BMIPP SPECT: comparative study with myocardial perfusion, left ventricular function, and histopathological findings.
We investigated myocardial fatty acid metabolism in taxan-induced myocardial damage in patients with advanced lung cancer.


METHODS
Twenty-five patients with non-small-cell lung cancer were treated with taxan combined with carboplatin intravenously for three cycles. Myocardial SPECT imaging using 99mTc-methoxyisobutyl isonitrile (MIBI) and 123I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) was performed successively before and after chemotherapy. Regional uptake scores of BMIPP and MIBI were visually assessed and total uptake scores and the number of abnormal segments were calculated. Left ventricular ejection fraction (LVEF) was obtained by first-pass radionuclide angiocardiography using MIBI. Postmortem pathological examination was performed in 5 patients.


RESULTS
Total BMIPP uptake scores after chemotherapy were significantly lower than those before chemotherapy (23.4 +/- 3.4 vs. 26.6 +/- 0.8; p < 0.001). Mean LVEF showed a significant decrease after chemotherapy. Of the 25 patients, 4 exhibited a decrease in LVEF of more than 10%, 1 had a decrease in LVEF to below 50%, and 1 developed congestive heart failure. These 6 patients had significant decreases in total BMIPP uptake scores and increases in the number of abnormal segments as compared with the other 19 patients. Histopathological examination of myocardial tissue showed interstitial edema and disarrayed myocardial cells.


CONCLUSIONS
Taxan impairs myocardial fatty acid metabolism. 123I-BMIPP myocardial SPECT is useful for evaluating the cardiotoxicity induced by taxan.
Department of Pulmonology, Yamada Red Cross Hospital, Mie, Japan. k1saito@carrot.ocn.ne.jp
Kimimasa
K
Saito
Kan
K
Takeda
Kyoko
K
Imanaka-Yoshida
Hiroshi
H
Imai
Takao
T
Sekine
Yuko
Y
Kamikura
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D000077143:Docetaxel; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000009:adverse effects* / Q000627:therapeutic use; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013318:Stroke Volume; D043823:Taxoids / Q000009:adverse effects* / Q000627:therapeutic use; D017256:Technetium Tc 99m Sestamibi
D000972:Antineoplastic Agents, Phytogenic; D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D019275:Radiopharmaceuticals; D043823:Taxoids; C049338:iodofiltic acid; D000077143:Docetaxel; D017256:Technetium Tc 99m Sestamibi; D017239:Paclitaxel