Prediction of Functional Improvement of Ischemic Myocardium With 123I-BMIPP SPECT and 99mTc-Tetrofosmin SPECT Imaging-A Study of Patients With Large Acute Myocardial Infarction and Receiving Revascularization Therapy-

Abstract

or clinicians, the functional outcome of acute myocardial infarction (AMI) is a great concern, particularly because a large AMI often causes congestive heart failure in its clinical course. Emergency percutaneous coronary intervention (PCI) is now performed in many hospitals for patients with AMI 1-4 to salvage ischemic Circulation Journal Vol.69, March 2005 myocardium. However, in the 1970s, Heyndrickx et al reported that regional contraction remained abnormal for more than 3 h after a 5-min coronary occlusion in conscious dogs, 5 which established that the contractility of viable ischemic myocardium often does not recover at once, even though circulation to the ischemic myocardium has been restored. This phenomenon is termed myocardial stunning. [6][7][8] Whether ischemic myocardium is stunned and regains its contractility is a matter of great concern. 18 Ffluorodeoxyglucose (FDG) positron-emission tomography (PET) is considered to be the most useful method of evaluating viability of the myocardium, 9-11 but it requires a cyclotron, which limits its availability. We compared the ability of a combination of 123 I-methyl pentadecanoic acid (BMIPP) and 99m Tc tetrofosmin (TF) single-photon emission tomography (SPECT), a combination of 18 F-FDG PET Background 18 F-fluorodeoxyglucose (FDG) positron-emission tomography (PET) is assumed to be the most useful method of evaluating the viability of the myocardium, but its use is limited by the need for a cyclotron. In the present study, the ability of a combination of 99m Tc-tetrofosmin (TF) and 123 I--methyliodophenyl pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT), a combination of 18 F-FDG PET and 123 I-BMIPP SPECT, and a combination of 18 F-FDG PET and 99m Tc-TF SPECT were compared to predict functional improvement of ischemic myocardium after a large acute myocardial infarction (AMI). Methods and ResultsTen patients with large AMI were studied by 99m Tc-TF SPECT, 123 I-BMIPP SPECT and 18 F-FDG PET within 3 weeks. Six months later, 99m Tc-TF imaging was performed. All patients underwent successful revascularization, and had no restenosis. Regional tracer uptake was scored using a 4-point scale in 20 segments of the SPECT and PET images. When the defect score of 123 I-BMIPP SPECT exceeded the defect score of 99m Tc-TF SPECT or 18 F-FDG PET by 1 point or more, and when the defect score of 99m Tc-TF SPECT exceeded the defect score of 18 F-FDG PET by 1 point or more, the segment was considered to show mismatching. When the defect score was the same in 2 tracers, the segment was considered to show matching. 99m Tc-TF imaging at 3 weeks and 6 months used quantitative gated SPECT (QGS) to score wall motion using a 6-point scale (-1= dyskinesis, 0= akinesis, 1= severe hypokinesis, 2= moderate hypokinesis, 3= mild hypokinesis, and 4= normokinesis).

Serial change in perfusion–metabolism mismatch after coronary artery bypass grafting

“…After at least 6 h of fasting, patients were injected intravenously with 148 MBq of 123 I-BMIPP (Nihon Medi-Physics Co Ltd), and scanned 20 min later for 10 min in the same manner as for 99m Tc-TF SPECT imaging [ 8 , 9 ]. The interval between 99m Tc-TF and 123 I-BMIPP SPECT imaging was within 7 days.…”

A novel fluorescently-labeled long-chain fatty acid analog for the study of fatty acid metabolism in cultured cells

“…The copyright holder for this this version posted December 8, 2022. ; https://doi.org/10.1101/2022.12.06.519076 doi: bioRxiv preprint for examining LCFA flux under various heart conditions in humans [26,27]. Hence, Alexa680-BMPP, which has a BMIPP skeleton, is likely to enter the same metabolism as 123 I-BMIPP once it is successfully imported into cells.…”

Fatty acid metabolism and myocardial perfusion imaging for the evaluation of global left ventricular dysfunction following acute myocardial infarction: Comparisons with echocardiography

“…A combined study of myocardial metabolic tracer with perfusion tracer provides clues about the myocardial status in the healing stage of MI [6][7][8]. Perfusion-metabolism mismatch represents impaired but viable myocardium in the risk area, which is involved in functional recovery after revascularization in patients with AMI [9,10,31]. Therefore both the echocardiography and cardiac scintigraphy are cardinal imaging modalities for diagnosis and prognosis of patients with AMI.…”