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The evolution of the oxidative metabolism of (11)C acetate parallels the recovery of left ventricular(LV) contraction following acute myocardial infarction(AMI). This study was designed to unravel, for the first time, the impact of the global washout rate(WR) of (123)I-beta-methyl-p-iodophenylpentadecanoic acid (BMIPP) on the recovery of LV function followingAMI, as evidenced from conventional echocardiography.Twenty consecutive patients (age: 58 +/- 13 years; 16 males and 4 females) with ST-segment elevation myocardial infarction (STEMI) were enrolled and all of them underwent successful percutaneous coronary intervention (PCI). (123)I-BMIPP cardiac scintigraphy was performed at 7 +/- 3 days after admission. The WR was calculated from the polar map and the regional BMIPP defect score was calculated using a 17 segment model. Echocardiography was performed within 24 h of admission and at 3 months to record the ejection fraction (EF), the wall motion score index (WMSI), the ratio of the mitralinflow velocity to the early diastolic velocity (E/E0)and the myocardial performance index (MPI). The mean global WR of the BMIPP was 22.12 +/- 7.22%, and it was significantly correlated with the improvement of the WMSI (r = 0.61, P\0.004). However,the relative changes of the EF, E/E0 and MPI were not correlated with the WR. The BMIPP defect score (18 +/- 10) was significantly correlated with the WMSI on admission (r = 0.74, P = 0.0002), but the defect score was not correlated with the relative changes of any of the echocardiographic parameters. We proved that the WR of the BMIPP is a promising indicator of improvement of the LV wall motion (WMSI) following ST-segment elevation myocardial infarction and successful reperfusion.

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<p><strong>Objective:</strong> Endothelial dysfunction and atherosclerosis may be associated with subclinical hypothyroidism (SCH) in multiple ways. The intima-media thickness of the common carotid artery (CIMT) is an important parameter for early atherosclerotic change. Previously several studies addressed the association between SCH and CIMT. Some studies indicate that SCH might be related to increase CIMT, while other studies revealed no significant association.   The aim of the study was to further examine the relationship between CIMT and SCH patients in our own laboratory setting in Bangladesh.</p><p><strong>Patients and Methods: </strong>This cross sectional study was carried out at the Institute of Nuclear Medicine and Allied Sciences (INMAS), Dhaka Medical College Hospital Campus, Dhaka during the period of January 2016 to October 2016. The study included 56 consecutive patients. Out of 56 patients, 26 were in SCH group and 30 were in euthyroid control group. CIMT was measured in each subject via High resolution B-mode ultrasonography. Data were analyzed between these two groups in respect to age, sex, BMI, and mean CIMT.</p><p><strong>Results: </strong>Out of 56 subjects, 26 were SCH group and 30 were euthyroid control group. Male to female ratio was 3:23 and 9:21 in SCH and control groups respectively. The mean age was 30±7.4 and 32±8.7 years in SCH and control groups respectively. The mean BMI was 25.6±4.7 kg/m² in SCH and 25.1±4.1 kg/m² in control group. The mean CIMT was significantly (p≤0.05) higher in SCH group (Right-0.80±0.05 mm, Left-0.80±0.07 mm) than control group (Right-0.60±0.05 mm, Left- 0.61±0.05 mm). SCH group was further subdivided into two groups with a cut off value of serum TSH at 10 mIU/L.  The mean CIMT was significantly higher in SCH with TSH above 10 mIU/L than SCH group with TSH less than 10 mIU/L (p≤0.05). Pearson’s rank correlation test showed significant positive correlation between both CIMT and TSH values.</p><p><strong>Conclusion: </strong>Our study showed that CIMT was significantly higher in SCH group than euthyroid control group. The CIMT values were positively correlated with the TSH values. Therefore we may conclude that SCH is an independent risk factor for atherosclerosis  in addition to other  classical risk factors.</p><p>Bangladesh J. Nuclear Med. 19(2): 123-127, July 2016</p>

A B S T R A C TObjective: Following acute myocardial infarction (AMI) the area of myocardial perfusion and metabolism mismatch is designated as dysfunctional viable myocardium. 123I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) is clinically very useful for evaluating myocardial fatty acid metabolism, and 99 mTc-Tetrofosmin (TF) is a widely used tracer for myocardial perfusion. This study was designed to evaluate the degree of discrepancy between BMIPP and TF at the subacute state of AMI.Methods: Fifty-two patients (aged 59 ± 10 years; mean 46 years) with AMI were enrolled, and all of them underwent percutaneous coronary intervention (PCI). Patients were classified according to ST-T change and PCI timing.123 I-beta-methyl iodophenyl pentadecanoic acid and TF cardiac scintigraphy were performed on 7 ± 3.5 days of admission using a dual headed gamma camera. Perfusion and fatty acid metabolism defect were scored on a 17 segments model. Results:The mean BMIPP defect score on early and delayed images were 16.67 ± 10.19 and 16.25 ± 10.40, respectively. The mean TF defect score was 10 ± 7.69. Defect score of BMIPP was significantly higher than that of the TF (P < 0.0001; 95% CI 4.32-7.02), and there was a strong correlation between perfusion and metabolism defect score (r = 0.89, P < 0.00001). Forty-seven (90%) patients showed mismatched defect (BMIPP > TF), and 5 (10%) patients showed matched defect (BMIPP = TF). Mismatched defect score (MMDS) was significantly higher in patients with ST-segment elevation myocardial infarction (STEMI) than that of non-ST-segment elevation myocardial infarction (NSTEMI) (P < 0.041; 95% CI 0.11-5.19). Conclusion:At the subacute state of AMI, most of the patients showed perfusion-metabolism mismatch, which represents the dysfunctional viable myocardium, and patients with STEMI showed higher mismatch.