A compartment model analysis for investigation of myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy.
OBJECTIVE
The purpose of this study was to investigate the myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy (HCM) from dynamic SPECT through a compartment model analysis.


METHODS
Twenty-four normal controls, seven patients with left ventricular hypertrophy (LVH) due to essential hypertension (eHT), and 30 patients with HCM were studied. 123I-BMIPP and 99mTc-tetrofosmin SPECT were performed. All the myocardium was divided into 13 segments, and a total of 390 segments of HCM were categorized into early, moderately and severely advanced HCM segments, based on these SPECT imaging. By using the myocardial and blood pool time-activity curves, BMIPP pharmacokinetics were analysed through a two-compartment model. We defined k1 and k2 as influx and outflux rate constants between blood and myocardial reversible component, and k3 as the specific uptake rate constant between myocardial reversible and irreversible compartments.


RESULTS
The averages of k3 in HCM were higher than in normal. In contrast, the averages of k1/k2 in HCM were lower than in normal, and gradually decreased with progression of HCM. There are no significant differences in these indexes between normal controls and patients with LVH due to eHT.


CONCLUSIONS
k3 might be a sensitive predictor for early detection of HCM, and k1/k2 could be a useful index to evaluate its progression. A mathematical compartment model analysis with a BMIPP SPECT study might be useful not only for identification of HCM in very early stage, but also for evaluation of the progression of HCM.
Department of Radiology, Asahikawa Medical College, Japan. okizaki@asahikawa-med.ac.jp
Atsutaka
A
Okizaki
Noriyuki
N
Shuke
Junichi
J
Sato
Tomoaki
T
Sasaki
Naoyuki
N
Hasebe
Kenjiro
K
Kikuchi
Tamio
T
Aburano
D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D018450:Disease Progression; D004452:Echocardiography / Q000379:methods; D005227:Fatty Acids / Q000378:metabolism*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007457:Iodine Radioisotopes; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009206:Myocardium / Q000378:metabolism / Q000473:pathology*; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals