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Clinical value of iodine-123 beta-methyliodophenyl pentadecanoic acid (BMIPP) myocardial single photon emission computed tomography for predicting cardiac death among patients with chronic heart failure.

Abstract
In the present study, the effectiveness of 123I-beta-methyliodophenyl pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT) for predicting cardiac death of patients with chronic heart failure was evaluated. Abnormalities of fatty acid metabolism are found in patients with chronic heart failure and BMIPP was developed as a tracer for scintigraphic assessment of myocardial fatty acid utilization. The study group comprised 74 patients with chronic heart failure with a left ventricular ejection fraction (LVEF) <45% on left ventriculography or radionuclide angiocardiography. They underwent both 201Tl SPECT and BMIPP SPECT. The uptake of tracer was scored semiquantitatively from 0 (normal) to 4 (defect) in 20 segments and a total defect score (TDS) for all 20 segments was calculated. On planar images the mediastinum to heart count ratio (H/M) was calculated for the BMIPP and Tl studies, and the H/M(BMIPP):H/M(Tl) (H/M(BMIPP) divided by H/M(Tl)) was also calculated. The mean follow-up period was 660 days and there were 17 cases of cardiac death. Multivariate analysis identified H/M(BMIPP):H/M(Tl) (p<0.05) and LVEF (p<0.05) as independent predictors of cardiac death. The receiver-operating characteristic curve of H/M(BMIPP):H/M (Tl) was situated to the left relative to LVEF. Analysis of the myocardial metabolism by BMIPP SPECT can predict the high-risk patients with chronic heart failure.
AuthorsRyu Sasaki, Isao Mitani, Takashi Usui, Yutaka Kitamura, Yuzuru Yoshii, Toshiyuki Ishikawa, Kazuaki Uchino, Nobukazu Takahashi, Kazuo Kimura, Satoshi Umemura
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 67 Issue 11 Pg. 918-24 (Nov 2003) ISSN: 1346-9843 [Print] Japan
PMID14578597 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Fatty Acids
  • Iodine Radioisotopes
  • Iodobenzenes
  • Radiopharmaceuticals
  • iodofiltic acid
Topics
  • Aged
  • Death
  • Fatty Acids (metabolism)
  • Female
  • Follow-Up Studies
  • Heart Failure (diagnosis, mortality)
  • Humans
  • Iodine Radioisotopes
  • Iodobenzenes
  • Male
  • Middle Aged
  • Myocardium (metabolism)
  • Predictive Value of Tests
  • ROC Curve
  • Radiopharmaceuticals (standards)
  • Severity of Illness Index
  • Stroke Volume

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