Biomedical subjects

I Matsunari

Publications and source records attributed to I Matsunari.

At least 37 records · Page 2Linked to original sources

PubMed1998

Myocardial perfusion scintigraphy to evaluate patients after coronary stent implantation.

UNLABELLED: Coronary stent implantation is an increasingly accepted revascularization method. The 20%-30% restenosis rate during the first 6 mo requires a close follow-up of the patients. Since there is very little data available defining the role of perfusion scintigraphy in the management of this population, the aim of this study was to assess the diagnostic performance of stress myocardial perfusion imaging for detecting restenosis in patients after coronary stent implantation. METHODS: In 82 patients, 93 rest or stress SPECT studies were performed using 201Tl and 99mTc-hexakis-2-methoxyisobutyl isonitrile to evaluate 99 vascular territories with implanted coronary stents. The average interval between the stent implantation and the scintigraphic study was 210.5 +/- 129.6 days. The scintiscans were visually evaluated. A stress-induced perfusion defect with reversibility at rest was used as the criterion for stent restenosis. RESULTS: Coronary angiography revealed a stenosis of > 50% diameter in the region of the stent in 19 arteries, while in 80 arteries there was no evidence of restenosis angiographically. With perfusion scintigraphy, 15/19 vascular territories with restenosed stents showed stress-induced perfusion abnormalities (sensitivity = 79%), while 62/80 territories without restenosis did not (specificity = 78%). In territories without a myocardial infarction (n = 48), sensitivity and specificity values were 8/8 (100%) and 36/44 (82%), and in territories with a myocardial infarction (n = 47) 7/11 (64%) and 26/36 (72%), respectively. Side branch stenosis was fairly frequent in patients without stent restenosis but with a reversible perfusion pattern on their scintiscan (8/18); however, these stenoses were induced infrequently by the stents (3 cases). CONCLUSION: Using the criterion of defect reversibility, stress perfusion SPECT can accurately detect restenoses of coronary artery stents. This method is most accurate for evaluating patients without a previous myocardial infarction in the stented vascular territory.

Coronary Disease↗

PubMed1998

Absent myocardial iodine-123-BMIPP uptake and platelet/monocyte CD36 deficiency.

UNLABELLED: Global absence of myocardial 123I-15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (BMIPP) uptake is occasionally noted, and it reflects myocardial long-chain fatty acid uptake abnormality. CD36, a membrane glycoprotein expressed on platelet, monocyte and endothelial cells, may contribute to myocardial fatty acid transport, and its deficiency has been reported in a small subset of the population. We hypothesized that CD36 deficiency may be related to absent myocardial BMIPP uptake. Thus, we investigated CD36 expression of platelet/monocyte in patients with absent myocardial BMIPP uptake. METHODS: Peripheral blood of 7 patients with global absence of myocardial BMIPP uptake (3 of 7 patients in one family) and 3 control subjects were examined in flow cytometric analysis. Platelet/monocyte surface CD36 was detected by using OKM5, an anti-CD36 mouse monoclonal antibody. RESULTS: There were no apparent relationships between specific clinical symptoms and absent myocardial BMIPP uptake. None of the blood samples of the 7 patients were stained with OKM5 on the platelet/monocyte cell surface, indicating that all of these patients were Type I CD36-deficient subjects. In contrast, all the control subjects showed normal staining. CONCLUSION: The fact that rare Type I CD36 deficiency was observed in all patients with absent myocardial BMIPP uptake suggests that CD36 plays a role in the myocardial long-chain fatty acid uptake process in humans.

Adult↗

PubMed1997

Quantitative rest technetium-99m tetrofosmin imaging in predicting functional recovery after revascularization: comparison with rest-redistribution thallium-201.

OBJECTIVES: This study was undertaken to 1) compare the regional myocardial tracer distributions between rest technetium (Tc)-99m tetrofosmin and rest-redistribution thallium (Tl)-201 images in patients with coronary artery disease and left ventricular dysfunction; and 2) assess the comparative values of these agents for predicting functional recovery after revascularization. BACKGROUND: Tc-99m tetrofosmin is a new myocardial perfusion imaging agent, but its role for detecting viable myocardium is still unclear. METHODS: Thirty-six patients with coronary artery disease and left ventricular dysfunction underwent rest Tc-99m tetrofosmin, rest-redistribution Tl-201 and gated blood pool scintigraphy. In 21 patients with successful revascularization confirmed by follow-up angiography, gated blood pool scintigraphy was repeated after revascularization. Optimal threshold cutoffs to separate reversible from irreversible dysfunction were determined by receive operating characteristic analysis. RESULTS: Regional Tc-99m tetrofosimin activity highly correlated with redistribution Tl-201 activity (r = 0.93). The diagnostic performance for predicting functional recovery, as measured by the area under the receiver operating characteristic curves, measured 0.66 +/- 0.07 (mean +/- SD) for Tc-99m tetrofosmin and 0.67 +/- 0.07 for Tl-201 (p = 0.60, 96.7% power to detect difference in area of 0.10). The optimal threshold cutoffs for viability were considered to be 50% of peak activity for Tc-99m tetrofosmin and 55% of peak activity for Tl-201. The positive and negative predictive values for reversible dysfunction were, respectively, 69% and 82% for Tc-99m tetrofosmin and 69% (p = 0.99 vs. Tc-99m tetrofosmin) and 71% (p = 0.66 vs. Tc-99m tetrofosmin) by Tl-201. CONCLUSIONS: The diagnostic performance of quantitative rest Tc-99m tetrofosmin imaging in predicting functional recovery after revascularization is comparable to that of rest-redistribution Tl-201.

Aged↗

PubMed1997

Myocardial technetium-99m-tetrofosmin and technetium-99m-sestamibi kinetics in normal subjects and patients with coronary artery disease.

UNLABELLED: This study was designed to compare the tracer kinetics between 99mTc-sestamibi and 99mTc-tetrofosmin in a heterogeneous group of 24 patients admitted for routine perfusion imaging. METHODS: Twelve patients were studied with 99mTc-tetrofosmin and 12 with 99mTc-sestamibi. In each group, six patients had a low likelihood for coronary artery disease, and six patients had angiographically proven coronary artery stenoses of > 75% or previous myocardial infarction. Analysis of myocardial and liver uptake and clearance as well as target-to-organ contrasts were performed with planar stress images. RESULTS: Myocardial uptake of 99mTc-tetrofosmin was higher from 5 min (0.37 +/- 0.12 counts/pixel x MBq-1, p = 0.008) to 60 min (0.32 +/- 0.10 counts/pixel x MBq-1, p = 0.04) compared to 99mTc-sestamibi. Biological half-life for 99mTc-tetrofosmin (278 +/- 32 min) in normal myocardium was significantly shorter (p = 0.008) than for 99mTc-sestamibi (680 +/- 45 min). Biological liver half-life for 99mTc-tetrofosmin (67 +/- 16 min) was also significantly shorter (p = 0.02) than for 99mTc-sestamibi (136 +/- 18 min). Heart-to-lung ratios for 99mTc-tetrofosmin (2.49 +/- 0.43 at 5 min to 2.66 +/- 0.55 at 60 min) and 99mTc-sestamibi (2.52 +/- 0.37 at 5 min to 2.95 +/- 0.50 at 60 min) were similar. Whereas heart-to-liver ratios for 99mTc-tetrofosmin (1.04 +/- 0.24 at 5 min, increasing to 1.51 +/- 0.44 at 60 min) were significantly higher from 30-60 min postinjection (p = 0.05 at 30 min to p = 0.02 at 60 min) compared to the 99mTc-sestamibi (0.83 + 0.16 at 5 min to 1.08 +/- 0.27 at 60 min). CONCLUSION: Technetium-99m-tetrofosmin displays a shorter myocardial half-life compared to 99mTc-sestamibi. The rapid liver clearance of 99mTc-tetrofosmin, combined with comparable myocardial retention, resulted in higher heart-to-liver ratios but similar heart-to-lung contrasts compared to 99mTc-sestamibi from 30-60 min.

Coronary Disease↗

PubMed1997

Significance of late redistribution thallium-201 imaging after rest injection for detection of viable myocardium.

UNLABELLED: The aim of this study was to determine whether late redistribution imaging after rest injection of 201Tl would provide further information on myocardial viability over conventional rest-early redistribution 201Tl imaging. METHODS: Twenty-nine patients with coronary artery disease and left ventricular dysfunction underwent rest, early (3-4 hr) and late (20-24 hr) redistribution 201Tl and gated blood pool studies. In 14 patients with successful revascularization, gated blood pool study was repeated after the coronary intervention. RESULTS: Nine of 29 patients showed early redistribution, and six additional patients showed further redistribution on the late images. Of 136 segments with initial 201Tl defects, 18 showed early redistribution, and 10 showed late redistribution. When a threshold of 60% of peak activity was used as an index of myocardial viability, only a small fraction (3%) of the initial 201Tl defects were additionally considered viable by the late images. In 14 patients who underwent revascularization, the positive (69%) and negative (87%) predictive values of the early redistribution images for functional recovery were similar to those obtained by the late images (68% and 86%, respectively). CONCLUSION: Although late redistribution after rest injection of 201Tl occasionally occurs, most of the clinically relevant information on myocardial viability may be obtained by conventional rest-early redistribution 201Tl imaging when the defect severity is considered an index of tissue viability.

Aged↗

PubMed1997

Assessment of improvement of myocardial fatty acid uptake and function after revascularization using iodine-123-BMIPP.

UNLABELLED: We used beta-methyl iodophenyl pentadecanoic acid (BMIPP) to evaluate changes in myocardial fatty acid utilization before and after revascularization and the ability of BMIPP to predict functional recovery in patients with chronic coronary artery disease. METHODS: Thirty-four patients with chronic coronary artery disease (60 +/- 10 yr) underwent BMIPP and 201Tl SPECT (stress-reinjection 201Tl in 29 patients and resting 201Tl in 5 patients) before and 2-5 wk after percutaneous transluminal angioplasty (n = 23) or coronary artery bypass surgery (n = 11). Cardiac function was evaluated by gated blood-pool scintigraphy (n = 26) or two-dimensional echocardiography (n = 8) before and after revascularization. RESULTS: In 32 patients with reduced BMIPP uptake before revascularization, scintigraphic findings with 201Tl improved in 28 patients after revascularization. In these 28 patients, BMIPP uptake improved in 20 patients (71%). Wall motion abnormality was observed in 16 of these 20 patients before revascularization, with 15 showing wall motion improvement after revascularization. In eight patients without improvement of BMIPP uptake, despite 201Tl uptake improvement, wall motion abnormality was observed in four patients before revascularization; after revascularization, one showed wall motion recovery, and three did not. Ejection fraction (EF) improvement after revascularization correlated best with the area of improved BMIPP uptake (r = 0.84, p < 0.0005). EF improvement also correlated with the area of improved reinjection 201Tl uptake (r = 0.54, p < 0.05) and improved 201Tl uptake at stress after revascularization (r = 0.48, p < 0.05). The area of discordant uptake of BMIPP less than reinjection 201Tl uptake before revascularization was a good predictor of EF improvement after revascularization (r = 0.58, p < 0.01); however, the area of reversible 201Tl defect was not (r = 0.34, p = 0.15). CONCLUSION: In patients with chronic coronary artery disease, functional improvement after revascularization is closely related to the recovery of BMIPP uptake. Discordant BMIPP uptake less than reinjection 201Tl uptake is a potential predictor of functional recovery.

Angioplasty, Balloon, Coronary↗

PubMed1996

Comparison of defect size between thallium-201 and technetium-99m tetrofosmin myocardial single-photon emission computed tomography in patients with single-vessel coronary artery disease.

Defect size on exercise-rest technetium (Tc)-99m tetrofosmin myocardial perfusion imaging was compared with that on exercise-reinjection thallium-201 imaging with 20 patients with 1-vessel coronary artery disease. In each patient, exercise-reinjection thallium-201 single-photon emission computed tomography (SPECT) and exercise-rest Tc-99m tetrofosmin SPECT imaging were performed. For visual analysis of the obtained SPECT images, the left ventricular myocardium was divided into 20 segments based on 3 short-axis slices from the apical, middle, and basal ventricular levels. For quantitative analysis, a square region of interest was placed on the center of each segment which was used for visual analysis, and relative regional activity to the normal reference region was calculated for each segment. By visual interpretation of the images, exercise Tc-99m tetrofosmin imaging showed a smaller defect size than exercise thallium-201 imaging (6.9 +/- 3.9 vs 8.8 +/- 3.0 segments, p <0.01). In contrast, rest Tc-99m tetrofosmin imaging showed a defect size similar to that on reinjection thallium-201 imaging (5.9 +/- 3.6 vs 5.6 +/- 3.9 segments, p = NS). Similarly, the mean defect sizes during exercise determined by quantitative analysis were smaller on Tc-99m tetrofosmin SPECT than those on thallium-201 SPECT at all tested threshold cutoff points ranging from 50% to 70%, whereas there were no significant differences in defect sizes between rest Tc-99m tetrofosmin and reinjection thallium-201 imaging. These data indicate that exercise Tc-99m tetrofosmin SPECT defect size determined either by visual analysis or by quantitative analysis may be smaller than on exercise thallium-201 SPECT.

Aged↗

PubMed1996

Technetium-99m tetrofosmin uptake in lung cancer: comparison with thallium-201.

Technetium-99m tetrofosmin and thallium-201 lung SPECT imaging were performed in a patient with adenocarcinoma of the lung. Significant activities in the lung lesion were clearly depicted on both technetium-99m tetrofosmin and thallium-201 SPECT imaging. The early uptake, delayed uptake ratios and retention indices of the tumor were 2.75, 2.39 and -1.31 for thallium-201 imaging and 3.09, 2.27 and -26.5 for technetium-99m tetrofosmin imaging, respectively. This preliminary report suggests that technetium-99m tetrofosmin may have potential as a tumor imaging agent.

Adenocarcinoma↗

PubMed1996

Impaired fatty acid uptake in ischemic but viable myocardium identified by thallium-201 reinjection.

Iodine 123-labeled 15-iodophenyl-3-methyl-pentadecanoic acid (BMIPP) has been proposed as a potential myocardial fatty acid probe. We studied BMIPP uptake in ischemic myocardium identified by thallium reinjection. Fifty-five patients with coronary artery disease who had persistent defects on standard exercise-redistribution thallium imaging were investigated. Patients underwent exercise-redistribution-reinjection thallium and resting BMIPP imaging. BMIPP uptake less than that seen with thallium on reinjection imaging was observed in 105 (82%) of 128 myocardial segments with new fill-in after thallium reinjection and 87 (37%) of 238 segments with reversible thallium defects. In contrast, only 32 (19%) of 166 segments with no fill-in showed discordantly decreased BMIPP uptake. Quantitative analysis showed reduction in BMIPP activity compared with differential uptake of thallium, an index of resting myocardial perfusion, especially in the area of fill-in (53.5% +/- 15.0% vs 76% +/- 12.1% of peak; p<0.01). These observations are consistent with impaired fatty acid uptake in ischemic myocardium, particularly in the area of fill-in after thallium reinjection.

Adult↗

PubMed1996

Early and delayed technetium-99m-tetrofosmin myocardial SPECT compared in normal volunteers.

UNLABELLED: This study was performed to test the feasibility of early SPECT imaging with 99mTc-tetrofosmin with the presence of high hepatic activity. METHODS: Thirteen normal volunteers were injected 600-740 MBq of 99mTc-tetrofosmin at rest and were imaged at 10 min and 1 hr after injection. The SPECT images were reconstructed for 180 degrees 360 degrees data. The early and delayed SPECT and anterior planar projection images were analyzed. RESULTS: After excluding one subject because of high hepatic activity overlapping to the myocardium, 4 of 12 subjects (33%) had abnormal scans with reduced uptake in the inferior wall on the early 180 degrees SPECT image. In contrast, only one (8%) showed equivocally reduced uptake on the 360 degrees SPECT image. In the delayed images, all subjects had a normal 180 degrees and 360 degrees SPECT scan. Quantitative data showed reduced regional activities in the inferior wall on the early SPECT scan, especially in the 180 degrees data. There were no changes in the mean anterior-to-inferior ratio in the anterior planar projection images over time, suggesting that the reduced activity in the early SPECT images reflected an artifactual effect. CONCLUSION: Our data indicate that it would be best to perform late imaging in patients with suspected coronary artery disease using 99mTc-tetrofosmin.

Adult↗

PubMed1996

[Residual activity or defect reversibility on stress-redistribution-reinjection 201T1 SPECT: which is the better marker of myocardial viability?].

Although both residual T1 activity and defect reversibility are used as a marker of myocardial viability on stress-redistribution-reinjection T1 (T1-RI) imaging, it is not yet fully understood which marker better predicts reversible dysfunction after revascularization. The aim of this study was to assess the comparative efficacies of these criteria for prediction of functional recovery after revascularization. Twenty-five patients (LVEF 41%) who underwent successful revascularization were studied with T1-RI SPECT and gated blood pool scintigraphy before revascularization. The gated blood pool study was repeated at mean 2 months after revascularization. The left ventricular myocardium was divided into 9 segments and the mean regional activities were calculated for each segment. In this study, two independent criteria were used as a viability index; (A) the presence of residual T1 activity (> 50% of peak) on the final image (reinjection image), (B) reversible defect (> 10% increase on the subsequent images) or normal T1 uptake (> 80% of peak) on the initial image. Functional recovery occurred in 51 of 88 dysfunctional segments. The presence of residual T1 activity was a highly sensitive (96%) but poorly specific (35%) marker of reversible dysfunction, while a reversible defect or normal T1 uptake was a less sensitive (67%) but more specific (59%) predictor of functional recovery. In conclusion, defect reversibility provides unique information on myocardial viability which cannot be obtained by assessing residual T1 activity alone.

Aged↗

PubMed1995

Impairment of regional fatty acid uptake in relation to wall motion and thallium-201 uptake in ischaemic but viable myocardium: assessment with iodine-123-labelled beta-methyl-branched fatty acid.

In coronary artery disease, discrepancy in the uptake of thallium-201 and of methyl-branched fatty acid at rest has been described. The purpose of this study was to evaluate iodine-123 labelled beta-methyl-branched fatty acid (BMIPP) myocardial uptake and wall motion at rest in segments with stress-induced ischaemia identified by stress 201Tl tomography in patients with chronic coronary artery disease. 123I-BMIPP myocardial tomography was performed at rest and was compared with the findings of exercise-reinjection 201Tl tomography in 45 patients with chronic coronary artery disease. Regional wall motion was evaluated by contrast left ventriculography in 36 patients. Among 237 segments with reversible 201Tl defects, equally decreased uptake on both reinjection 201Tl and BMIPP images was observed in 93 (39%), more severely decreased uptake of BMIPP in 118 (50%) and more severely decreased uptake of reinjection 201Tl in 26 (11%). On the other hand, among 90 segments with non-reversible 201Tl defects, each pattern was observed in 71 (79%), 6 (7%) and 13 (14%) segments, respectively. When comparing the ischaemic segments with and without more severely reduced uptake of BMIPP than of reinjection 201Tl, wall motion was impaired to a greater extent in the segments with more severely reduced uptake of BMIPP than of reinjection 201Tl [severe hypo- or dyskinesis was present in 64 (70%) of 91 segments and in 24 (22%) of 110 segments, respectively, P<0.005]. In patients with chronic coronary artery disease, resting fatty acid uptake was frequently more reduced than reinjection 201Tl in the segments with stress-induced ischaemia, while in most of the fixed perfusion defects BMIPP and reinjection 201Tl uptake decreased concordantly. In ischaemic myocardium, wall motion was impaired to a greater extent in those segments which showed more severely reduced uptake of BMIPP than of reinjection 201Tl. In ischaemic but viable myocardium, discordant BMIPP uptake less than reinjection 201Tl uptake may indicate metabolic alterations and wall motion abnormality at rest independent of perfusion abnormalities. In conclusion, the combination of resting BMIPP and stress-reinjection 201Tl imaging may provide information on metabolic alterations and wall motion abnormality at rest independent of perfusion abnormalities.

Adult↗

PubMed1995

Myocardial viability assessment with technetium-99m-tetrofosmin and thallium-201 reinjection in coronary artery disease.

UNLABELLED: Exercise-rest 99mTc-tetrofosmin myocardial perfusion images with a 2-day protocol was compared to exercise-redistribution-reinjection 201Tl images to assess the ability of 99mTc-tetrofosmin to detect viable myocardium. METHODS: We studied 25 patients with coronary artery disease and regional or global left ventricular dysfunction. Myocardial SPECT images with 99mTc-tetrofosmin were obtained 10 min after injection during exercise and 1 and 3 hr after rest injection. Within 1 wk of the 99mTc-tetrofosmin study, exercise-redistribution-reinjection 201Tl SPECT imaging was performed. RESULTS: Visual analysis demonstrated concordance between 201Tl and 99mTc-tetrofosmin imaging for defect reversibility in 126 of 209 segments (60%), with initial defects on both exercise 201Tl and 99mTc-tetrofosmin images. In the remaining discordant 83 segments (40%), 73 (88%) appeared nonreversible on 99mTc-tetrofosmin imaging but were reversible on 201Tl imaging. CONCLUSION: On the basis of defect reversibility by visual analysis, exercise-rest 99mTc-tetrofosmin imaging underestimates myocardial viability compared to 201Tl reinjection imaging. The identification of viable myocardium with both 99mTc-tetrofosmin and 201Tl can be greatly enhanced to a similar degree if the severity of reduction in activity within nonreversible defects is considered. These two agents may provide comparable information about myocardial viability by quantitative analysis of defect severity.

Coronary Disease↗

PubMed1995

Improved myocardial fatty acid utilization after percutaneous transluminal coronary angioplasty.

Exercise-reinjection 201Tl imaging and resting 20-min and 3-hr BMIPP imaging were performed before and 4 mo after percutaneous transluminal coronary angioplasty (PTCA) in a patient with effort angina. Before PTCA, exercise 201Tl imaging showed decreased 201Tl activity in the septal wall, with significant fill-in on the reinjection 201Tl image. The resting 20-min BMIPP image showed decreased activity in the septal wall, with a slight redistribution on the 3-hr BMIPP image. The 201Tl and BMIPP images 4 mo after PTCA showed significant improvement in the 201Tl pattern and BMIPP uptake in the septal wall with no abnormally decreased activities.

Aged↗

PubMed1995

[Evaluation of myocardial fatty acid metabolism in the area of fill-in after thallium reinjection in patients with prior myocardial infarction].

Myocardial fatty acid utilization in the area with thallium fill-in after reinjection was assessed using 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid (BMIPP). We studied 22 patients with prior myocardial infarction that revealed persistent defects on standard exercise-redistribution thallium imaging. In each patient, exercise-redistribution-reinjection thallium imaging was performed. Within two weeks of the thallium study, resting BMIPP imaging was performed 20 min after injection of BMIPP (148 MBq). Following qualitative analysis of the obtained thallium and BMIPP images, quantitative analysis was performed on the basis of relative regional uptake. Of 199 myocardial segments that showed persistent defects on exercise-redistribution images, 73 segments showed apparent fill-in on the reinjection images (fill-in positive), and the remaining 126 segments did not (fill-in negative). When BMIPP images were compared with the corresponding thallium reinjection images, reduced BMIPP uptake compared with thallium were frequently observed in the area of fill-in positive segments (65 of 73 segments, 89%). Quantitative analysis also showed decrease in BMIPP activity compared to thallium activity in the area of fill-in (49.7 +/- 16.1 vs. 65.8 +/- 16.0%, p < 0.001). In contrast, only 24 of the 126 fill-in negative segments (19%) showed lower BMIPP uptake than thallium. These results suggest that impaired fatty acid utilization in the area of thallium new fill-in after reinjection already exists at resting condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1995

[Value of 123I-BMIPP scintigraphy in patients with ischemic heart disease: comparison with exercise 201Tl SPECT].

To evaluate 123I labeled beta-methyl-branched fatty acid (BMIPP) myocardial uptake at rest in the segment with and without stress induced ischemia in patients with coronary artery disease, 123I-beta-methyl-branched fatty acid myocardial scintigraphy was performed at rest and was compared with the findings of stress-reinjection 201Tl myocardial scintigraphy in 31 patients with coronary artery disease. In 159 ischemic myocardial segments, equally decreased uptake on both reinjection 201Tl and fatty acid images was observed in 64 segments, more severely decreased uptake of fatty acid in 76 segments, and more severely decreased uptake of reinjection thallium in 19 segments. On the other hand, in 53 non-reversible defects, each patterns was observed in 41, 3, and 9 segments respectively. When comparing the ischemic segments with more reduced uptake of fatty acid than reinjection thallium (Group 1) and the ischemic segments with equally or less reduced fatty acid uptake than reinjection thallium (Group 2), wall motion was more severely impaired in Group 1 than in Group 2 (severe hypo- to dyskinesis was present in 32 of 54 segments in group 1 and in 21 of 75 segments in group 2, p < 0.005). In conclusion, in patients with coronary artery disease, resting fatty acid uptake was frequently more reduced than reinjection 201Tl in the segments with stress induced ischemia and wall motion was more impaired in these segments. BMIPP myocardial imaging may provide information on metabolic alterations at rest independent of perfusion abnormalities in patients with coronary artery disease.

Aged↗

PubMed1994

Relationship between various parameters derived from 123I-labelled beta-methyl-branched fatty acid whole-body scintigraphy and left ventricular ejection fraction in patients with ischaemic heart disease.

Heart uptake and clearance of 123I-15-(p-iodophenyl)-3(R,S)-methyl- pentadecanoic acid (BMIPP) by whole-body scintigraphy in relation to left ventricular ejection fraction (LVEF) was evaluated in 34 patients with ischaemic heart disease. At 45 and 210 min after injection, anterior whole-body images were obtained. In each patient, multigated blood pool scintigraphy was also performed, and LVEF was calculated. The percentage heart uptake of BMIPP did not have a significant correlation with LVEF (R = -0.299, NS). In contrast, there was a positive correlation between LVEF measured by multigated blood pool scintigraphy and BMIPP count density of the heart (R = 0.467, P = 0.005). Myocardial BMIPP washout rate also positively correlated with LVEF (R = 0.472, P = 0.005). In addition to these observations, there was a positive correlation between the BMIPP count density of the heart and myocardial BMIPP washout rate (R = 0.0543, P = 0.001). Thus, the BMIPP count density of the heart and myocardial BMIPP washout rate derived from BMIPP whole-body scintigraphy directly correlated with LVEF. However, the correlations between these parameters and LVEF were not strong enough to allow left ventricular dysfunction to be assessed precisely.

Adult↗

PubMed1994

[Quantitative analysis of 123I-BMIPP imaging in relation to exercise-redistribution 201Tl in patients with old myocardial infarction].

Myocardial kinetics of 123I-labeled 15-(p-iodophenyl)3R,S-methylpentadecanoic acid (BMIPP) was evaluated with BMIPP imaging in conjunction with stress-201Tl. We studied 20 patients with old myocardial infarction. BMIPP SPECT was obtained at 20 min and 3 h after injection. On a separate day, exercise stress-201Tl SPECT was performed at 10 min and 3 h after injection. Then, left ventricular myocardium was divided into 20 segments. For quantitative analysis, in each SPECT data, the maximum value (average counts per pixel) of all 20 myocardial segments was taken as 100%; the other values were calculated as a percentage of this maximum (Relative regional uptake, RRU). On the basis of stress-201Tl pattern, the myocardial segments were classified into 4 groups; normal 201Tl uptake, reversible 201Tl defect, fixed 201Tl defect and 201Tl defect with reverse redistribution. The 20 min BMIPP showed reduced activity compared with 3 h-201Tl (p < 0.001), especially in the area of 201Tl redistribution (50/111 segments, 45%), implicating impaired fatty acid utilization at resting condition. The washout rate of the segments with reversible 201Tl defect (-1.6 +/- 13.9%) was significantly lower than that of the segments with normal 201Tl uptake (9.0 +/- 9.8%) and fixed 201Tl defect (3.8 +/- 12.9%). Thus, BMIPP in combination with stress 201Tl imaging provides precise informations of impaired myocardial fatty acid utilization in patients with old myocardial infarction.

Adult↗