We evaluated the characteristics of myocardial
fatty acid metabolism in patients with
left ventricular hypertrophy (LVH). Myocardial imaging with 123I-beta-methyl iodophenyl
pentadecanoic acid (
BMIPP) was performed in 28 patients with
hypertrophic cardiomyopathy (HCM), 15 patients with hypertensive
heart disease (HHD), 13 patients with
aortic stenosis (AS) and 8 normal controls (NC). The patients with HCM consisted of 13 patients of asymmetric septal
hypertrophy (ASH), 7 patients of diffuse
hypertrophy (Diffuse-HCM) and 8 patients of apical
hypertrophy (APH). Planar and SPECT images of
BMIPP were acquired 15 minutes and 4 hours after tracer injection. Resting 201Tl SPECT images and echocardiography were also performed on other days. We calculated heart/mediastinum count ratio and washout rate of
BMIPP by using planar image. In patients with LVH, the incidence of reduced
BMIPP uptake was more frequent than that of reduced 201Tl uptake. In delayed images, more than 60% of patients with LVH reduced
BMIPP uptake, especially remarkable for patients with ASH and APH. The washout rate of all cardiac hypertrophic disorders was tended to be higher than that of normal subjects. Reduced
BMIPP uptake was frequently found in septal portion of anterior and inferior wall in patients with ASH, in inferior wall in patients with Diffuse-HCM and HHD, in apex in patients with APH and AS. These results suggest that
BMIPP scintigraphy can differentiate three types of
cardiac hypertrophy.