title: Delayed recovery of fatty acid metabolism after transient myocardial ischemia: a potential imaging target for "ischemic memory".
abstract: The myocardium preferentially oxidizes free fatty acids for energy production. However, the dependency of this metabolic pathway on oxygen makes this process vulnerable to ischemia. The energy requirements of the myocardium are subsequently met by the oxidation of carbohydrates, particularly glucose. Recovery of fatty acid metabolism lags behind restoration of perfusion, resulting in the phenomenon of metabolic stunning. This decrease of fatty acid utilization following ischemia can be imaged with fatty acid radiotracers, particularly beta-Methyl-p-(123)I-iodophenyl pentadecanoic acid (BMIPP), which demonstrates markedly limited metabolism via beta-oxidation, resulting in prolonged retention in the cardiomyocyte. Thus, in patients presenting with chest pain and no prior myocardial infarction, abnormal BMIPP uptake at rest reflects metabolic alteration caused by the preceding ischemia, also termed ischemic memory.
authors: Division of Nuclear Medicine, Department of Diagnostic Radiology, University of Maryland Hospital and School of Medicine, Baltimore, MD 21201-1595, USA.
authors: Steven A
authors: SA
authors: Messina
authors: Omer
authors: O
authors: Aras
authors: Vasken
authors: V
authors: Dilsizian
mesh_terms: D000818:Animals; D003326:Coronary Circulation; D003952:Diagnostic Imaging; D005227:Fatty Acids / Q000378:metabolism*; D006801:Humans; D053858:Metabolic Networks and Pathways; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology / Q000503:physiopathology; D019275:Radiopharmaceuticals
chemical_list: D005227:Fatty Acids; D019275:Radiopharmaceuticals