Simultaneous assessment of Tc-99m-sestamibi and I-123-BMIPP myocardial distribution in patients with myocardial infarction: evaluation of left ventricular function with ECG-gated myocardial SPECT.

Abstract

123I-labeled 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid (BMIPP) is a branched-chain free fatty acid that is used to evaluate various cardiac diseases. The aim of the present study was to investigate the relationship between myocardial perfusion (99mTc-sestamibi) and BMIPP uptake, and to correlate perfusion and metabolic alterations with regional left ventricular dysfunction in patients with myocardial infarction (MI). ECG-gated dual-isotope myocardial SPECT was performed on 130 patients with MI with sestamibi (555 MBq) and BMIPP (148 MBq). The patients were classified into 3 groups according to PTCA therapy and the interval between the onset of infarction and RI injection (OR time). Group A (n = 56) included patients whose OR time was less than one month and who had undergone successful PTCA, Group B (n = 36) had OR times of less than one month and had conservative medical therapy, and Group C (n = 38) had OR times of over one month. The severity scores of the dual-isotope images were calculated from the defect scores in 9 segments. From the ECG-gated SPECT data with sestamibi, the left ventricular ejection fraction (LVEF; %) and regional wall motion were determined automatically using the QGS program LVEF obtained from gated SPECT correlated well with the severity scores for sestamibi and BMIPP (r = -0.68 and -0.76, respectively). The delta severity scores (BMIPP scores - sestamibi scores) of Group A were significantly higher than those of the other two groups (3.6 +/- 3.0 vs. 1.5 +/- 1.7 and 1.0 +/- 1.4, p < 0.001 ). The rate of dysfunctional segments with normal sestamihi distribution was significantly higher in Group A than in Group C (20.7% vs. 6.7%, p < 0.001). ECG-gated dual-isotope SPECT is useful since myocardial perfusion, fatty acid metabolism and left ventricular function can be analyzed during a single examination, so that this procedure has the potential to provide comprehensive information when evaluating patients with ischemic heart disease.

• Authors: S Kumita, K Cho, H Nakajo, M Toba, T Kijima, S Mizumura, T Kumazaki, J Sano, K Munakata, H Kishida, T Takano
• Journal: Annals of nuclear medicine (Ann Nucl Med) Vol. 14 Issue 6 Pg. 453-9 (Dec 2000) ISSN: 0914-7187 [Print] Japan
• PMID: 11210098 (Publication Type: Journal Article)

Chemical References

• Fatty Acids
• Iodine Radioisotopes
• Iodobenzenes
• Radiopharmaceuticals
• iodofiltic acid
• Technetium Tc 99m Sestamibi

Topics

• Adult
• Aged
• Aged, 80 and over
• Electrocardiography
• Fatty Acids (pharmacokinetics)
• Female
• Gated Blood-Pool Imaging
• Humans
• Iodine Radioisotopes (pharmacokinetics)
• Iodobenzenes (pharmacokinetics)
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, physiopathology)
• Myocardium (metabolism)
• Radiopharmaceuticals (pharmacokinetics)
• Technetium Tc 99m Sestamibi (pharmacokinetics)
• Tomography, Emission-Computed, Single-Photon
• Ventricular Function, Left (physiology)