Diagnostic value of 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) in patients with chest pain. Comparison with rest-stress 99mTc-tetrofosmin SPECT and coronary angiography.

Abstract

BACKGROUND:

Basic and clinical studies have indicated that 15-(p-[(123)I] iodophenyl)-3-(R, S) methylpentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) can identify ischemic myocardium without evidence of myocardial infarction by the regional decline of tracer uptake. The present study compared BMIPP SPECT with rest-stress myocardial perfusion imaging (MPI) findings and coronary angiography (CAG) in 150 patients with acute chest pain.

METHODS AND RESULTS:

Patients with acute chest pain who underwent all of the following tests were selected: MPI at rest-stress, BMIPP SPECT at rest and CAG. Organic coronary artery stenosis (>or=75%) was observed in 46 patients, 27 patients had total or subtotal coronary occlusion by spasm in the spasm provocation test on CAG and the remaining 77 patients had no significant coronary artery stenosis or spasm. The sensitivity of BMIPP at rest to detect organic stenosis was significantly higher (54%) than that of rest-MPI (33%, p<0.005), but lower than that of stress-MPI (76%, p=0.05). The sensitivity of BMIPP at rest to detect spasm was significantly higher (63%) than that of both rest-MPI (15%; p<0.001) and stress-MPI (19%; p<0.001). Overall, the sensitivity of BMIPP at rest to detect both organic stenosis and spasm was significantly higher (58%) than that of rest-MPI (26%; p<0.001), despite having no significance with that of stress-MPI (55%). The specificity was not significantly different among the three imaging techniques.

CONCLUSION:

Resting BMIPP SPECT is an alternative method to stress MPI for identifying patients with not only organic stenosis but also spasm without the need for a stress examination.

• Authors: Yuko Kawai, Koichi Morita, Yoichi Nozaki, Takanori Ohkusa, Masayuki Sakurai, Nagara Tamaki
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 68 Issue 6 Pg. 547-52 (Jun 2004) ISSN: 1346-9843 [Print] Japan
• PMID: 15170090 (Publication Type: Case Reports, Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Fatty Acids
• Iodine Radioisotopes
• Iodobenzenes
• Organophosphorus Compounds
• Organotechnetium Compounds
• Radiopharmaceuticals
• iodofiltic acid
• technetium tc-99m tetrofosmin

Topics

• Aged
• Chest Pain (diagnosis)
• Coronary Angiography
• Coronary Artery Disease (diagnosis)
• Fatty Acids (standards)
• Female
• Humans
• Iodine Radioisotopes
• Iodobenzenes (standards)
• Male
• Middle Aged
• Organophosphorus Compounds
• Organotechnetium Compounds
• Radiopharmaceuticals (standards)
• Tomography, Emission-Computed, Single-Photon (methods)