Comparison of Resting β-Methyl-Iodophenyl Pentadecanoic Acid (BMIPP) and Thallium-201 Tomography Using Quantitative Polar Maps in Patients With Unstable Angina

Abstract

We compared resting beta-methyl-iodophenyl pentadecanoic acid (BMIPP) tomography with resting thallium-201 tomography in 28 patients with unstable angina. Tracer distribution was displayed on a polar map and compared with a normal standard deviation map obtained from a group of 12 normal subjects. The extent scores and severity scores obtained by BMIPP were significantly greater than those obtained by thallium-201. Confirmation by coronary angiography revealed the sensitivity of the methods in identifying patients to be 89% for BMIPP and 54% for thallium-201. There were significant differences between BMIPP and thallium-201 in the sensitivities of detecting postischemic jeopardized myocardium in the area supplied by the right coronary artery (RCA; 53% vs 18%, p < 0.05), left circumflex artery (LCX; 78% vs 39%, p < 0.025) and all 3 vessels combined (71% vs 35%, p < 0.001) but no significant differences in specificity (RCA: 82% vs 64%; LCX: 70% vs 90%; and total 3 vessels combined: 75% vs 79%). In conclusion, resting BMIPP tomography is more sensitive than resting thallium-201 tomography in detecting postischemic myocardial damage in patients with unstable angina.

Prediction of Coronary Artery Lesions in Unstable Angina by Iodine 123 Beta-Methyl Iodophenyl Pentadecanoic Acid (BMIPP), a Fatty Acid Analogue, Single Photon Emission Computed Tomography at Rest

“…There have been studies to estimate myocardial metabolic abnormalities in hypertension,12 hypertrophic cardiomyopathy,13 and myocardial infarctionl4,15 by 123I_gMIPP imaging as well as several to estimate myocardial metabolic abnormalities by using 123I_BMIpp SPECT imaging in UA on relatively small numbers of patients. [16][17][18][19] Thus, the present study was undertaken to examine the ability and limitations of 123I_BMIPP SPECT imaging to evaluate myocardial segmental metabolic abnormalities and to predict coronary lesions in a large number of patients with UA.…”

Myocardial scintigraphy using a fatty acid analogue detects coronary artery disease in hemodialysis patients

“…Iodine-123 -methyl iodophenyl-pentadecanoic acid ( 123 I-BMIPP) is a branched FFA analogue characterized by resistance to b-oxidation. Recent studies indicate possible effectiveness of single-photon emission computed tomography (SPECT) using 123 I-BMIPP as a tracer in diagnosis of organic coronary lesions, unstable angina pectoris, or coronary spasm without exercise or drugs [12][13][14][15][16][17][18][19][20][21][22]. In the present study, we investigated whether 123 I-BMIPP SPECT could be useful in screening for coronary artery disease in ESRD patients undergoing maintenance hemodialysis.…”

Role of Fatty Acid Imaging with 123I- β-methyl-p-123I- Iodophenyl-Pentadecanoic Acid (123I-BMIPP) in Ischemic Heart Diseases

“…In patients with unstable angina, discordant BMIPP uptake less than thallium has also been observed frequently [66][67][68][69]. In patients with unstable angina without prior myocardial infarction, comparison of BMIPP image and stress thallium scan performed after stabilization of their condition demonstrated that BMIPP decrease was associated with stress perfusion abnormality in 44 of 57 (77%) segments and degree of BMIPP reduction correlated with the degree of perfusion abnormality at stress, degree of wall motion abnormality, and severity of coronary artery stenosis [66].…”