Impaired myocardial fatty acid metabolism detected by123I-BMIPP in patients with unstable angina pectoris: Comparison with perfusion imaging by99mTc-sestamibi

Takeishi, Yasuchika; Sukekawa, Hiroyasu; Saito, Haruo; Nishimura, S; Shibu, T; Sasaki, Yasuhiko; Tomoike, Hitonobu

doi:10.1007/bf03165038

Cited by 19 publications

(7 citation statements)

References 25 publications

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“…The 1211-BMIPP defects are commonly observed in the area with normal perfusion examined by resting 201 T1 or 99 mTcSestamibi scintigraphy in ischemic heart disease. [7][8][9][10] As reported in the past, most angina patients show signs of the perfusion defect only during chest pain, 27.28 and a few during the pain free period. [27][28][29] Consequently mismatched defects of ' 23 1-BMIPP with normal perfusion is a sensitive marker for detecting abnormal myocardium.…”

Section: Discussionmentioning

confidence: 86%

Resting123I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

et al. 1998

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This study was undertaken to assess the diagnostic value of resting 123I-BMIPP scintigraphy in patients with effort angina pectoris. One hundred and four patients underwent scintigraphic and angiographic examinations. The subsets of the patients were stable effort angina pectoris (stable type) in 27 cases, new onset of effort angina pectoris (new onset type) in 21 cases, and worsening effort angina pectoris (worsening type) in 35 cases. The remaining 21 cases were subjects without evidences of coronary artery disease (non-CAD). 123I-BMIPP was injected under resting and pain free condition, then data for single photon emission tomography (SPECT) were acquired. The positive regional 123I-BMIPP defects in three coronary territories were visually judged on the tomographic images. The overall sensitivity to diagnose the patients was 62.6% (52/83) and the overall specificity to exclude non-CAD subjects was 95.2% (20/21). The detection rate in each subset of the disease was 48.1% (13/27) in stable type, 47.6% (10/21) in new onset type and 77.1% (27/35) in worsening type (p < 0.05 versus two other types). For detection of stenosed vessels, the overall sensitivity was 41.4% (56/148) and the overall specificity was 93.8% (152/164). The rate of detection of stenosed vessels was 31.7% (13/41) in stable type, 31.4% (11/35) in new onset type, and 55.6% (40/72) in worsening type (p < 0.05 versus two other types). Vessels with 75% stenosis were more sensitively detected in the worsening type (33.3%; 4/12) compared to the remaining two types (8.3%; 1/12) even though the difference was not significant. The resting 123I-BMIPP scintigraphy was therefore valuable in diagnosing patients with effort angina pectoris and involved coronary arteries especially in the subset of patients with worsening type.

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Section: Discussionmentioning

confidence: 86%

Resting123I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

et al. 1998

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“…Many clinical studies have also indicated that BMIPP SPECT can identify ischemic myocardium without evidence of myocardial infarction as well as the present study [14][15][16]26,27]. Such decreased myocardial uptakes of BMIPP have been frequently observed in the presence of normal perfusion tracer distribution, and thus metabolic imaging with BMIPP is more sensitive for detecting myocardial ischemia than perfusion imaging in patents with unstable angina.…”

Section: Perfusion/metabolism Dual Spect In Redefined Uamentioning

confidence: 79%

Dual-isotope myocardial SPECT in patients with redefined myocardial infarction

Fukushima

Seino

Kumita

et al. 2005

International Journal of Cardiology

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“…In patients with unstable angina, mismatched BMIPP uptake less than thallium has also been observed frequently [66][67][68][69]. Comparison of BMIPP image in 19 patients with unstable angina without prior myocardial infarction 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].…”

Section: Unstable Angina Pectorismentioning

confidence: 99%

Metabolic imaging using SPECT

Taki

Matsunari²

2007

Eur J Nucl Med Mol Imaging

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In normal condition, the heart obtains more than two-thirds of the energy from oxidative metabolism of the long chain fatty acids, although a wide variety of substrates such as glucose, lactate, keton bodies and aminoacids are also utilized. In ischemic myocardium, on the other hand, oxidative metabolism of free fatty acid is suppressed and anaerobic glucose metabolism play a major role for residual oxidative metabolism. Therefore, metabolic imaging can be an important technique for the assessment of various cardiac diseases and conditions. In SPECT, up to the present, several iodinated fatty acid traces have been introduced and studied. Of these, I-123 labeled 15-(p-iodophenyl)3R, S-methylpentadecanoic acid (BMIPP) has been the most commonly used tracers in clinical studies, especially in some of the European countries and Japan. In this review article the 1 characterization of the several fatty acid tracers for SPECT are described and basic and clinical utility of BMIPP are further discussed. IntroductionThe cardiac muscle metabolizes a variety of substrates by selecting appropriate ones available in the particular myocardial condition. In normal condition, fatty acids and glucose are the most preferred substrate for energy production, followed by lactate, amino acids, keton bodies. Approximately two-thirds or more of the total energy produced by myocardium is derived from fatty acid oxidation and the most of the remaining energy is covered by the glucose metabolism. Both fatty acid and glucose are catabolized to acetyl-COA through beta-oxidation and glycolysis and the metabolite is oxidized in the tricarboxylic acid (TCA) cycle. In various pathological conditions the myocardial metabolism can be changed significantly, for instance, in ischemia, oxidative metabolism of free fatty acid is decreased because ß-oxidation of fatty acid in mitochondria requires a large amount of oxygen, and glucose becomes the preferred substrate for anaerobic glycolysis that requires less oxygen consumption [1,2]. Therefore, imaging tracers that permit direct assessment of myocardial metabolism are desired to evaluate the pathophysiological changes in various heart disease. Current available tracers for metabolic imaging are several fatty acid tracers, 18 F-FDG for the evaluation of glucose metabolism, and 11 C-acetate for the

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Impaired myocardial fatty acid metabolism detected by123I-BMIPP in patients with unstable angina pectoris: Comparison with perfusion imaging by99mTc-sestamibi

Cited by 19 publications

References 25 publications

Resting123I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

Resting123I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

Dual-isotope myocardial SPECT in patients with redefined myocardial infarction

Metabolic imaging using SPECT

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