1
|
Otaki Y. Underrecognized Utility of 123I-BMIPP in CAD Diagnosis Outside of Japan. ANNALS OF NUCLEAR CARDIOLOGY 2024; 10:44-48. [PMID: 39635322 PMCID: PMC11612396 DOI: 10.17996/anc.24-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2024] [Accepted: 09/19/2024] [Indexed: 12/07/2024]
Abstract
123I-BMIPP (Iodine-123 labeled beta-methyl-p-iodophenyl-pentadecanoic acid) is a radiotracer that facilitates non-invasive assessment of myocardial fatty acid metabolism through single photon emission computed tomography imaging. Given that fatty acids serve as one of the primary energy sources for cardiac muscle, reduced uptake of 123I-BMIPP offers valuable insights into the pathophysiology of various cardiac conditions, particularly in coronary artery disease (CAD). Despite its reported efficacy, the use of 123I-BMIPP remains limited outside Japan, primarily due to regulatory and supply challenges. However, in Japan, 123I-BMIPP is clinically utilized for CAD patients with various ischemic conditions as the protocol does not require stress tests or contrast iodine and has a relatively short acquisition time. This review highlights the clinical applications of 123I-BMIPP across various conditions and aims to promote its broader adoption in clinical practice, both in Japan and internationally.
Collapse
Affiliation(s)
- Yuka Otaki
- Department of Radiology, Sakakibara Heart Institute, Tokyo, Japan
| |
Collapse
|
2
|
Nappi C, Panico M, Falzarano M, Vallone C, Ponsiglione A, Cutillo P, Zampella E, Petretta M, Cuocolo A. Tracers for Cardiac Imaging: Targeting the Future of Viable Myocardium. Pharmaceutics 2023; 15:pharmaceutics15051532. [PMID: 37242772 DOI: 10.3390/pharmaceutics15051532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/02/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
Ischemic heart disease is the leading cause of mortality worldwide. In this context, myocardial viability is defined as the amount of myocardium that, despite contractile dysfunction, maintains metabolic and electrical function, having the potential for functional enhancement upon revascularization. Recent advances have improved methods to detect myocardial viability. The current paper summarizes the pathophysiological basis of the current methods used to detect myocardial viability in light of the advancements in the development of new radiotracers for cardiac imaging.
Collapse
Affiliation(s)
- Carmela Nappi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Mariarosaria Panico
- Institute of Biostructure and Bioimaging, National Council of Research, 80131 Naples, Italy
| | - Maria Falzarano
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Carlo Vallone
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Paolo Cutillo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Emilia Zampella
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Mario Petretta
- IRCCS SYNLAB SDN, Via Gianturco 113, 80131 Naples, Italy
| | - Alberto Cuocolo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| |
Collapse
|
3
|
Morishima M, Kiriyama T, Miyagi Y, Otsuka T, Fukushima Y, Kumita SI, Ishii Y. Serial change in perfusion-metabolism mismatch after coronary artery bypass grafting. Ann Nucl Med 2021; 36:244-254. [PMID: 34822103 PMCID: PMC8897360 DOI: 10.1007/s12149-021-01696-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/14/2021] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Myocardial ischemia is known to suppress fatty acid metabolism and favor glucose metabolism. However, changes in myocardial metabolism after coronary revascularization are not fully elucidated. METHODS Thirty-eight patients with coronary artery disease were retrospectively enrolled. These patients had undergone stress perfusion single photon emission computed tomography (SPECT) and 123I-BMIPP SPECT in both the short-term (6.4 ± 4.7 months) and mid-term (29.9 ± 7.2 months) after isolated coronary artery bypass grafting. Tracer uptake was graded using a 17-segment, 5-point scoring model. Serial changes in SRS (summed rest score), SDS (summed difference score), the BMIPP score (total defect score of BMIPP), and the mismatch score (BMIPP score-SRS) were evaluated. In addition, persistent perfusion-metabolism mismatch (PM) was defined as mismatch score minus SDS of 3 or more during the mid-term postoperative period. The clinical parameters associated with PM were examined. RESULTS From short- to mid-term postoperative period, the extent of infarcted myocardium (SRS) did not change significantly (7.8 ± 8.0 to 7.1 ± 7.0, P = 0.117). The extent of ischemic myocardium (SDS), the BMIPP score and the mismatch score, which reflects perfusion-metabolism mismatch, were significantly improved (2.0 ± 2.8 to 0.7 ± 1.0, P = 0.010; 12.2 ± 9.0 to 9.5 ± 7.9, P < 0.001; 4.4 ± 3.7 to 2.5 ± 2.6, P < 0.001; respectively). Remarkably, perfusion-metabolism mismatch persisted in 13 patients (34%) even in the mid-term postoperative period. eGFR and SYNTAX score were independent predictors of persistent perfusion-metabolic mismatch in multivariable analysis (OR = 0.951, 95% CI 0.898-0.985, P = 0.010 and OR = 1.126, 95% CI 1.011-1.254, P = 0.031, respectively). The mismatch score both in the short- and mid-term significantly correlated with SYNTAX score (r = 0.400 and r = 0.472, respectively). CONCLUSIONS Fatty acid metabolism disturbance improved from short- to mid-term postoperative period in patients with successful reperfusion by coronary artery bypass grafting. However, in patients with severe atherosclerosis, impaired fatty acid metabolism was sustained until the mid-term postoperative period, even though ischemia had resolved.
Collapse
Affiliation(s)
- Motoko Morishima
- Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | | | - Yasuo Miyagi
- Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Toshiaki Otsuka
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.,Center for Clinical Research, Nippon Medical School, Tokyo, Japan
| | | | | | - Yosuke Ishii
- Department of Cardiovascular Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| |
Collapse
|
4
|
Imaging of myocardial fatty acid oxidation. Biochim Biophys Acta Mol Cell Biol Lipids 2016; 1861:1535-43. [PMID: 26923433 DOI: 10.1016/j.bbalip.2016.02.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 02/19/2016] [Accepted: 02/20/2016] [Indexed: 02/06/2023]
Abstract
Myocardial fuel selection is a key feature of the health and function of the heart, with clear links between myocardial function and fuel selection and important impacts of fuel selection on ischemia tolerance. Radiopharmaceuticals provide uniquely valuable tools for in vivo, non-invasive assessment of these aspects of cardiac function and metabolism. Here we review the landscape of imaging probes developed to provide non-invasive assessment of myocardial fatty acid oxidation (MFAO). Also, we review the state of current knowledge that myocardial fatty acid imaging has helped establish of static and dynamic fuel selection that characterizes cardiac and cardiometabolic disease and the interplay between fuel selection and various aspects of cardiac function. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk.
Collapse
|
5
|
Biswas SK, Sarai M, Yamada A, Motoyama S, Harigaya H, Hara T, Sugimoto K, Toyama H, Hishida H, Ozaki Y. Fatty acid metabolism and myocardial perfusion imaging for the evaluation of global left ventricular dysfunction following acute myocardial infarction: Comparisons with echocardiography. Int J Cardiol 2010; 138:290-9. [DOI: 10.1016/j.ijcard.2008.11.170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 11/16/2008] [Indexed: 10/21/2022]
|
6
|
The relationship between reverse redistribution of 99mTc-tetrofosmin in sub-acute phase and left ventricular functional recovery in chronic phase in patients with acute myocardial infarction. Ann Nucl Med 2009; 23:863-8. [DOI: 10.1007/s12149-009-0318-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Accepted: 10/14/2009] [Indexed: 10/20/2022]
|
7
|
Biswas SK, Sarai M, Toyama H, Yamada A, Motoyama S, Harigaya H, Hara T, Iwase M, Hishida H, Ozaki Y. (123)I-BMIPP and (99m)Tc-TF discordance on myocardial scintigraphy and it's correlation with functional recovery following acute myocardial infarction: role of conventional echocardiography. Int J Cardiovasc Imaging 2009; 25:765-75. [PMID: 19768573 DOI: 10.1007/s10554-009-9497-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 08/18/2009] [Indexed: 10/20/2022]
Abstract
(123)I-beta-methyl-iodophenyl pentadecanoic acid (BMIPP) and (99m)Tc-Tetrofosmin (TF) mismatch designated as stunned myocardium having both systolic and diastolic components. The degree of mismatch might reflect subsequent functional improvement, and this study was designed to unravel the impact of mismatched defect score (MMDS) on recovery of both systolic and diastolic function following acute myocardial infarction (AMI). Forty patients with recent AMI were recruited, and all of them underwent emergency percutaneous coronary intervention. Echocardiography and BMIPP and TF cardiac scintigraphy were performed on 7 +/- 3 days of admission. Follow up echocardiography was performed after 3 months. MMDS were compared with the systolic [ejection fraction (EF) and wall motion score index (WMSI)] and diastolic [peak velocity of early diastolic filling of mitral inflow/peak early diastolic velocity of the mitral annulus(E/E') and left atrial volume index(LAVI)] parameters. BMIPP defect score was significantly higher than the TF defect score and there was a strong positive correlation between them (r = 0.90, P < 0.00001). Thirty-two (80%) patients showed mismatched defect and rest 8(20%) showed matched defect. Of 32 patients 24(75%), 22(69%), 19(59%), and 20(62.5%) showed improved EF, WMSI, E/E' and LAVI respectively. Conversely out of 8 only 2(25%), 1(12.5%), and 2(25%) patients showed improvement of EF, WMSI and LAVI, respectively. E/E' was not improved in patients with matched defect. MMDS were significantly correlated with the improvement of EF (r = -0.46, P = 0.002), WMSI (r = 0.41, P = 0.007), E/E' (r = 0.56, P < 0.0002), and LAVI (r = 0.44, P = 0.004). Mismatched defect score could predict the approximate amount of viable dysfunctional myocardium, and the degree of mismatch showed a significant correlation with the improvement of both systolic and diastolic function.
Collapse
Affiliation(s)
- Shankar K Biswas
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Aichi, 470-1192, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Abstract
INTRODUCTION In normal condition, the heart obtains more than two-thirds of its energy from the oxidative metabolism of long chain fatty acids, although a wide variety of substrates such as glucose, lactate, ketone bodies and amino acids are also utilised. In ischaemic myocardium, on the other hand, oxidative metabolism of free fatty acid is suppressed and anaerobic glucose metabolism plays a major role in residual oxidative metabolism. Therefore, metabolic imaging can be an important technique for the assessment of various cardiac diseases and conditions. MATERIALS AND METHODS In SPECT, several iodinated fatty acid traces have been introduced and studied. Of these, (123)I-labelled 15-(p-iodophenyl)3-R, S-methylpentadecanoic acid (BMIPP) has been the most commonly used tracer in clinical studies, especially in some of the European countries and Japan. RESULTS AND DISCUSSION In this review article, several fatty acid tracers for SPECT are characterised, and the mechanism of uptake and clinical utility of BMIPP are discussed in detail.
Collapse
Affiliation(s)
- Junichi Taki
- Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa 920-8640, Japan.
| | | |
Collapse
|
9
|
Affiliation(s)
- Christopher J Pastore
- Division of Cardiology, Department of Medicine, Tufts-New England Medical Center, Boston, MA 02111, USA
| | | | | |
Collapse
|
10
|
Hatori T, Toyama T, Kasama S, Suguta M, Nakano A, Hasegawa A, Endo K, Kurabayashi M. 123I-MIBG imaging can be used to evaluate microvascular disturbance caused by embolization by microdebris after rotational atherectomy. Ann Nucl Med 2007; 21:137-44. [PMID: 17561584 DOI: 10.1007/s12149-006-0007-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND During rotational atherectomy (RA), the coronary atherosclerotic plaque is largely pulverized into microdebris, which may cause serious hemodynamic instability owing to significant segmental left ventricular asynergy embolization of the distal microvasculature by atheromatous debris and associated vasospasm. OBJECTIVE To evaluate the usefulness of 123I-metaiodobenzylguanidine (123I-MIBG) in the examination of microvascular embolization after RA. METHODS AND RESULTS Nineteen patients with stable effort angina pectoris who had undergone RA were evaluated in this study. Left ventricular ejection fraction (LVEF) was determined by left ventriculography immediately before and after RA. The serum concentration of creatine phosphokinase (CPK), creatine phosphokinase-myocardial band (CPK-MB) isozyme, and cardiac troponin-T was determined after RA. 99mTc-methoxyiso-butylisonitrile (99mTc-MIBI) and 123I-MIBG scintigraphic examinations were also performed 1 day after RA. The regional defect score (RDS) was determined from 99mTc-MIBI scintigraphic findings, while early and delayed RDS, heart-to-mediastinum count ratios (H/M ratios), and washout rate (WR) were determined from 123I-MIBG scintigraphy. After RA, the left ventriculographic LVEF mildly decreased by <10% in ten patients (group A), but it decreased by >10% in the remaining nine patients (group B). There were no differences in baseline clinical characteristics between the two groups. The CPK, CPK-MB isozyme, troponin-T, RDS by 99mTc-MIBI, H/M ratios, and WR after RA were similar in the two groups. However, the RDSs determined from early and delayed 123I-MIBG in group A were significantly lower than those in group B (4.5 +/- 3.8 vs. 13.4 +/- 10.8, P < 0.05; 9.0 +/- 6.3 vs. 17.7 +/- 10.0, P < 0.05, respectively). Moreover, there were significant correlations between delta LVEF and troponin-T (r = 0.54, P < 0.05) and RDSs of early and delayed 123I-MIBG (r = 0.46, P < 0.05; r = 0.64, P < 0.05, respectively). CONCLUSIONS These findings suggest that 123I-MIBG imaging can be used to evaluate microvascular disturbance caused by embolization by microdebris after RA.
Collapse
Affiliation(s)
- Takashi Hatori
- Department of Medicine and Biological Science, Graduate School of Medical Sciences, Gunma University, 3-39-15, Showa-machi, Maebashi, Gunma 371-0034, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Chikamori T, Yamashina A, Hida S, Nishimura T. Diagnostic and prognostic value of BMIPP imaging. J Nucl Cardiol 2007; 14:111-25. [PMID: 17276313 DOI: 10.1016/j.nuclcard.2006.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Kawasaki T, Akakabe Y, Yamano M, Miki S, Kamitani T, Kuribayashi T, Sugihara H. Gated Single-Photon Emission Computed Tomography Detects Subendocardial Ischemia in Hypertrophic Cardiomyopathy. Circ J 2007; 71:256-60. [PMID: 17251677 DOI: 10.1253/circj.71.256] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Patients with hypertrophic cardiomyopathy (HCM) sometimes develop subendocardial ischemia (SEI) in the left ventricle (LV). In the present study it was examined whether volumetric variables obtained by gated single-photon emission computed tomography (SPECT) are useful in detecting exercise-induced SEI in patients with HCM. METHODS AND RESULTS Exercise 99mTc-tetrofosmin myocardial scintigraphy was performed in 26 HCM patients having non-obstruction and mild hypertrophy with a ventricular septal thickness < or = 20 mm. SEI was quantified using software developed previously, and the results were correlated with volumetric variables obtained using Quantitative Gated SPECT software. Exercise-induced percentage change in LV end-systolic volume was higher in 9 HCM patients with SEI (25.8+/-3.1%) than in 17 patients without (10.0+/-2.5%, p=0.009), although the percentage change in LV end-diastolic volume was similar in the 2 groups. The receiver-operator characteristics curve of the percentage changes in LV end-systolic volume for the detection of SEI showed that the optimal cutoff was 17%. This cutoff point yielded a good diagnostic value for the presence of SEI with a sensitivity of 89%, specificity 82%, and likelihood ratio 5.04. CONCLUSIONS Gated SPECT technique is useful in detecting SEI during exercise in a select population of HCM patients.
Collapse
Affiliation(s)
- Tatsuya Kawasaki
- Department of Cardiology, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan.
| | | | | | | | | | | | | |
Collapse
|
13
|
Isobe S, Takada Y, Ando A, Ohshima S, Yamada K, Nanasato M, Unno K, Ogawa T, Kondo T, Izawa H, Inden Y, Hirai M, Murohara T. Increase in electrocardiographic R-waves after revascularization in patients with acute myocardial infarction. Circ J 2006; 70:1385-91. [PMID: 17062958 DOI: 10.1253/circj.70.1385] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The physiological mechanism of the increase in the electrocardiographic (ECG) R-wave voltage after revascularization in patients with acute myocardial infarction (MI) needs to be elucidated. METHODS AND RESULTS One hundred and thirty-eight MI patients (83: anterior MI, 45: inferior MI, 10: lateral MI) underwent ECG and echocardiography in both the acute and subacute phases after emergency revascularization, as well as a resting thallium-201/iodine-123 15-p-iodophenyl-3-(R,S)-methyl pentadecanoic acid myocardial scintigraphy in the acute phase. The total sum of the R-wave voltage (SigmaR) was calculated over multiple leads on ECG for each infarcted lesion. Scintigraphic defect on each tracer was expressed as the percentage (%) defect of the total left ventricular (LV) myocardium. The % defect-discordance on both images in the acute phase and the % increase in SigmaR and the absolute increase in LV ejection fraction from the acute to the subacute phase (DeltaEF) were also calculated. The SigmaR in the subacute phase was significantly greater than that in the acute phase (p<0.0001). The % increase in SigmaR significantly correlated with the DeltaEF (r=0.57, p<0.0001). The % increase in SigmaR also correlated with the % defect-discordance (r=0.68, p<0.0001). CONCLUSIONS The increase in the ECG R-wave voltage reflects not only the improvement in myocardial perfusion but also the presence of salvaged myocardium after revascularization in acute MI patients.
Collapse
Affiliation(s)
- Satoshi Isobe
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya 462-0802, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Hashimoto A, Nakata T, Tamaki N, Kobayashi T, Matsuki T, Shogase T, Furudate M. Serial alterations and prognostic implications of myocardial perfusion and fatty acid metabolism in patients with acute myocardial infarction. Circ J 2006; 70:1466-74. [PMID: 17062973 DOI: 10.1253/circj.70.1466] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Impaired fatty acid metabolism the myocardial infarction (MI)-related area has prognostic value, but can alter over time. The aim of this study was to correlate alterations in myocardial fatty acid uptake and perfusion assessed by serial imaging with future outcomes in post-MI patients. METHODS AND RESULTS Following 2 imaging procedures using 15-4-iodophenyl-3-(R,S)-methylpentadecanoic acid (BMIPP) and perfusion tracers at an 11-month interval, 97 patients with acute MI were followed up for 33 months with respect to the primary endpoints of death, non-fatal MI and heart failure. Regional tracer uptake was semi-quantified for both the MI-related and remote coronary territories. A large BMIPP defect relative to a perfusion defect appeared on MI-related coronary territories. Thirteen patients with cardiac events had a greater prevalence of large BMIPP and perfusion defect scores for the MI-related areas on the first scan, previous MI, diabetes mellitus, and worsening of perfusion tracer uptake in the MI-related area than those without cardiac events. Multivariate analysis identified worsening perfusion in the MI-related area on the second scan, a large BMIPP defect in the same area on the first scan and previous MI as significant predictors with chi-square values of 3.48, 6.41 and 6.84, respectively. A combination of 3 predictors significantly (p<0.05) increased the global chi-square value to 15.45 compared with each chi-square value. CONCLUSIONS The size of the infarct-related risk area assessed by early cardiac BMIPP imaging and deterioration of perfusion tracer uptake in the compromised area for the first 12 months following acute MI are related to future cardiac events, indicating a rationale for identifying metabolically damaged but viable myocardium for further risk stratification of post-MI patients.
Collapse
Affiliation(s)
- Akiyoshi Hashimoto
- Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo 060-0061, Japan.
| | | | | | | | | | | | | |
Collapse
|
15
|
Miyabe H, Ohte N, Iida A, Narita H, Yoshida T, Kimura G. Evaluation of Fatty Acid .BETA.-Oxidation in Patients With Prior Myocardial Infarction in Relation to Myocardial Blood Flow, Total Oxidative Metabolism, and Left Ventricular Wall Motion. Circ J 2005; 69:1459-65. [PMID: 16308492 DOI: 10.1253/circj.69.1459] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fatty acid metabolism in patients with myocardial infarction (MI) who undergo coronary reperfusion has not been fully elucidated and was investigated in the present study using positron emission tomography. METHODS AND RESULTS The clearance rate constant of 11C-acetate (acetate-Kmono) and that of 11C-palmitate (palmitate-Kmono) from the myocardium were calculated using a monoexponential equation in 14 patients with MI. A total of 155 regions of interest were classified based on coefficient of determination (R2) values of monoexponential curves for 11C-palmitate clearance: well fitted regions (R2>or=0.5) and poorly fitted regions (R2<0.5). Regional relative myocardial blood flow calculated from the initial distribution of 11C-acetate and left ventricular (LV) wall motion were also evaluated. Peak 11C-palmitate uptake (14,434+/-3,052 vs 12,016+/-3,088 counts/s, p<0.001) and percent clearance during acquisition (38.2+/-10.1 vs 23.6+/-11.4%, p<0.001) were significantly greater in the well fitted regions (n=111) than in the poorly fitted regions (n=44). Acetate-Kmono was significantly higher in the former than in the latter (0.0641+/-0.0099 vs 0.0476+/-0.0103 min-1, p<0.001). LV wall motion and regional relative blood flow were also significantly greater in the former regions. Palmitate-Kmono in the well fitted regions was significantly higher in normal LV wall motion areas than in hypokinesis areas (0.0363+/-0.0062 vs 0.0274+/-0.0057 min-1, p<0.001) CONCLUSIONS Maintenance of myocardial fatty acid beta-oxidation with better myocardial blood flow is substantial in the preservation of total myocardial oxidative metabolism and LV wall motion in patients with MI. The finding that the early-phase clearance of 11C-palmitate is fitted with a monoexponential curve may provide important information in the evaluation of myocardial fatty acid beta-oxidation.
Collapse
Affiliation(s)
- Hiromichi Miyabe
- Department of Internal Medicine and Pathophysiology, Nagoya City University Graduate School of Medical Sciences, and Department of Radiology, Nagoya City Sports and Rehabilitation Center, Japan
| | | | | | | | | | | |
Collapse
|