Reduced 123I-BMIPP uptake implies decreased myocardial flow reserve in patients with chronic stable angina

Abstract

Long-chain fatty acid (LCFA) is the main energy source for normal myocardium at rest. In ischemic myocardium, the main energy substrate shifts from LCFA to glucose. 123 I-BMIPP is a radiolabeled LCFA analogue. In chronic stable angina without previous infarction, we suppose that reduced 123 I-BMIPP uptake is related to the substrate shift in myocardium with decreased myocardial flow reserve (MFR). Conclusion: In chronic stable angina without previous infarction, reduced 123 I-BMIPP uptake implies decreased MFR.

123I-BMIPP delayed scintigraphic imaging in patients with chronic heart failure

“…The abnormal uptake of cardiac BMIPP is a sensitive marker of severe myocardial damage in patients with ischemic heart diseases [3][4][5], idiopathic dilated cardiomyopathy (DCM) [6][7][8], hypertrophic cardiomyopathy [9,10], and cardiac sarcoidosis [11]. Furthermore, myocardial fatty acid metabolic analysis with BMIPP imaging is an accepted prophylactic tool in strategies to prevent CHF [2,12].…”

Accelerated BMIPP uptake immediately after reperfused ischemia in the isolated rat heart model

“…This might be too late to visualize the alteration of BMIPP uptake on a minute-by-minute basis in the quite early phase of acute ischemia in man. (3) There are possibilities that fatty acid metabolism may be impaired as a result of occult and repeatable ischemia that is characterized by flow impairment in coronary artery disease [28], and it is unknown how fatty acid metabolism alters in the initial exposure to myocardial ischemia.…”

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

“…The results demonstrated that rest myocardial blood flow was preserved independent of BMIPP uptake. However, hyperemic myocardial blood flow was decreased in the area with reduced BMIPP uptake, resulting in the severity of impaired myocardial flow reserve correlated to the reduction of BMIPP uptake [79]. Thus, reduced BMIPP uptake implies impaired myocardial flow reserve and may reflects adaptive substrate shifts or metabolic remodeling in hibernating myocardium.…”