Thallium-201 and I-123 beta-methyl iodophenyl-pentadecanoic acid dual isotope single photon emission computed tomography for evaluating reperfusion injury after successful reperfusion therapy.
We report a reperfusion injury after rotational coronary atherectomy (RA) in a 66-year-old man with coronary artery disease. Submaximal exercise with thallium-201 single photon emission computed tomography (SPECT) imaging before reperfusion showed partially reversible perfusion defects in the apex and reversible perfusion defects in the anteroseptal area. Thallium-201 and I-123 beta-methyl iodophenyl-pentadecanoic acid (BMIPP) dual isotope SPECT was performed 5 days before and 1 hour after RA, and 1 month after RA. SPECT images at 1 hour after recovery of no reflow phenomenon after RA revealed enlargement of the defect sizes on thallium-201 and BMIPP uptakes in the anteroseptal area including the apex compared with those before RA. The defect size of thallium-201 uptake was progressively improved on 5 hour delayed redistribution imaging and 1 month after reperfusion compared with that of BMIPP uptake. In conclusion, the changes for the worse of thallium-201 uptake and fatty acid metabolism immediately after the no reflow phenomenon may indicate an injured membrane integrity with altered myocardial metabolism rather than myocardial ischemia. Thallium-201 and I-123 BMIPP dual isotope SPECT is useful for evaluating reperfusion injury after successful reperfusion therapy in a patient with acute coronary syndrome.
Akutsu
Yasushi
Y
Division of Cardiology, Department of Medicine, Showa University School of Medicine, Shinagawaku, Tokyo, Japan. hzn01233@s02.itscom.net
Yamanaka
Hideyuki
H
Nishimura
Hideki
H
Hamazaki
Yuji
Y
Kaneko
Kyouichi
K
Kodama
Yusuke
Y
Li
Hui-Ling
HL
Suyama
Jumpei
J
Shinozuka
Akira
A
Gokan
Takehiko
T
Kobayashi
Youichi
Y
D000368:Aged; D017073:Atherectomy / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000379:methods; D005080:Exercise Test; D005227:Fatty Acids; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D017202:Myocardial Ischemia / Q000473:pathology; D015427:Reperfusion Injury; D013794:Thallium Radioisotopes; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D013794:Thallium Radioisotopes; C049338:iodofiltic acid