ISSN:
1619-7089
Keywords:
Coronary artery disease
;
Fatty acid metabolism
;
123I-15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid
;
Thallium
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract 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-methylbranched fatty acid (BMIPP) myocardial uptake and wall motion at rest in segments with stress-induced ischaemia identified by stress201Tl tomography in patients with chronic coronary artery disease.123I-BMIPP myocardial tomography was performed at rest and was compared with the findings of exercise-reinjection201Tl 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 reversible201Tl defects, equally decreased uptake on both reinjection201Tl and BMIPP images was observed in 93 (39%), more severely decreased uptake of BMIPP in 118 (50%) and more severely decreased uptake of reinjection201Tl in 26 (11%). On the other hand, among 90 segments with non-reversible201Tl 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 reinjection201Tl, wall motion was impaired to a greater extent in the segments with more severely reduced uptake of BMIPP than of reinjection201Tl [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 reinjection201Tl in the segments with stress-induced ischaemia, while in most of the fixed perfusion defects BMIPP and reinjection201Tl 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 reinjection201Tl. In ischaemic but viable myocardium, discordant BMIPP uptake less than reinjection201Tl uptake may indicate metabolic alterations and wall motion abnormality at rest independent of perfusion abnormalities. In conclusion, the combination of resting BMIPP and stress-reinjection201Tl imaging may provide information on metabolic alterations and wall motion abnormality at rest independent of perfusion abnormalities.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01791146
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