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Heterogeneous myocardial distribution of iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) in patients with hypertrophic cardiomyopathy

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Abstract

It has been proposed that iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (123I-BMIPP) is an agent for myocardial fatty acid metabolism in animal models. The aim of the present study was to determine whether alterations in fatty acid uptake and/or utilization in patients with hypertrophic cardiomyopathy (HCM) could be detected by 123I-BMIPP. Myocardial imaging with 123I-BMIPP and thallium-201 (201Tl) was performed in 14 fasted patients. A dose of 111 MBq of 123I-BMIPP was administered intravenously at rest, and myocardial emission computed tomography was obtained 20 min and 3 h after injection. The 201Tl imaging was also performed within 1 week after the 123I-BMIPP study. The regional myocardial uptake and clearance of 123I-BMIPP and 201Tl were assessed quantitatively. The myocardial distribution of 123I-BMIPP was more heterogeneous than that of 201Tl in patients with HCM. The myocardial uptake of 123I-BMIPP was lower in the anteroseptal region of the left ventricle than in the posterolateral region (74% vs. 85%, P < 0.001). The anteroseptal wall showed a faster clearance of 123I-BMIPP than the posterolateral wall (33% vs. 27%, P < 0.01). Both a decreased uptake and rapid clearance of 123I-BMIPP were observed in the hypertrophied myocardium of the anteroseptal wall, where 201Tl uptake was normal or even increased. Myocardial segments with a markedly increased thickness showed a lower uptake and faster clearance of 123I-BMIPP than those with mild hypertrophy (uptake 73% vs. 82%, P < 0.05; clearance 30% vs. 25%, P < 0.05). Myocardial imaging with 123I-BMIPP was thus applicable to patients with HCM for detecting myocardial regions with altered fatty acid metabolism.

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Authors and Affiliations

  1. First Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, 990-23, Yamagata, Japan

    Yasuchika Takeishi, Junya Chiba, Shinya Abe, Ichiro Tonooka & Hitonobu Tomoike

  2. Department of Radiology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, 990-23, Yamagata, Japan

    Akio Komatani

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  1. Yasuchika Takeishi
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  2. Junya Chiba
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  3. Shinya Abe
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  4. Ichiro Tonooka
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  5. Akio Komatani
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  6. Hitonobu Tomoike
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Supported in part by Grants-in-Aid for Scientific Research (nos. 02454259, 03268224) from the Ministry of Education, Science and Culture, Japan, a grant for Research on Cardiovascular Disease (1S-1) from the Ministry of Health and Welfare, Japan, and a grant from Uehara, Memorial Foundation.

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Takeishi, Y., Chiba, J., Abe, S. et al. Heterogeneous myocardial distribution of iodine-123 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) in patients with hypertrophic cardiomyopathy. Eur J Nucl Med 19, 775–782 (1992). https://doi.org/10.1007/BF00182819

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  • DOI: https://doi.org/10.1007/BF00182819

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