title: Cardiac scintigraphic findings of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes: A case report.
abstract: A 49-year-old woman was admitted to hospital because of heart failure. She was diagnosed as having mitochondrial cardiomyopathy and diabetes mellitus. Echocardiography revealed a hypertrophic and poorly contracting left ventricle. A diagnosis of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes was established by muscle biopsy. She underwent technetium-99m-sestamibi ((99m)Tc-MIBI) and beta-methyl-p-(123)I-iodophenyl-pentadecanoic acid ((123)I-BMIPP) scintigraphic examinations. (99m)Tc-MIBI single-photon emission computed tomography revealed reduced tracer uptake in the hypertrophic left ventricular inferior wall. In contrast, there was an increase in (123)I-BMIPP uptake in the in the region of reduced (99m)Tc-MIBI uptake ((99m)Tc-MIBI/(123)I-BMIPP mismatch). There was rapid washout of (99m)Tc-MIBI from the myocardium (washout rate increased by 30%). Decreased (99m)Tc-MIBI and increased (123)I-BMIPP uptake ((99m)Tc-MIBI/(123)I-BMIPP mismatch) were the characteristics of cardiac involvement in mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes.
authors.affiliation: Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa;
authors.forename: Shinro
authors.initials: S
authors.lastname: Matsuo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Seigo
authors.initials: S
authors.lastname: Kinuya
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Sato
authors.forename: Naoya
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Horie