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Incremental predictive value of myocardial scintigraphy with 123I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

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Abstract

Purpose

It is unclear whether 123I-labelled β-methyl iodophenyl pentadecanoic acid (123I-BMIPP) myocardial scintigraphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether 123I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac events.

Methods

One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent 201Tl and 123I-BMIPP myocardial scintigraphy. Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34.5 months (12–63 months).

Results

Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of 123I-BMIPP TDSs had a significantly higher rate of MACE (P=0.007). Patients with mismatch between 201Tl and 123I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three). Adding 123I-BMIPP TDS and the mismatch improved the global chi-square value (χ 2=7.2)

Conclusion

Myocardial scintigraphy using 201Tl and 123I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone.

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References

  1. Zaret BL, Wacker FJT, Terrin ML, Forman SA, Williams DO, Knatterud GL, Braunwald E. Value of radionuclide rest and exercise left ventricular ejection fraction in assessing survival of patients after thrombolytic therapy for acute myocardial infarction: results of thrombolysis in myocardial infarction (TIMI) phase II study. J Am Coll Cardiol 1995;26:73–9

    Article  CAS  PubMed  Google Scholar 

  2. Anderson JL, Platia EV, Hallstrom A, Henthorn RW, Buckingham TA, Carlson MD, Carson PE. Interaction of baseline characteristics with the hazard of encainide, flecainide, and moricizine therapy in patients with myocardial infarction: a possible explanation for increased mortality in the cardiac arrhythmia suppression trial (CAST). Circulation 1994;90:2843–52

    CAS  PubMed  Google Scholar 

  3. Tamaki N, Kawamoto M, Takahashi N, Yonekura Y, Magata Y, Nohara R, Kambara H, Sasayama S, Hirata K, Ban T. Prognostic value of an increase in fluorine-18 deoxyglucose uptake in patients with myocardial infarction: comparison with stress thallium imaging. J Am Coll Cardiol 1993;15:1621–7

    Google Scholar 

  4. Huitink JM, Visser FC, Bax JJ, van Lingen A, Groenveld AB, Teule GJ, Visser CA. Predictive value of planar 18F-fluorodeoxyglucose imaging for cardiac events in patients after acute myocardial infarction. Am J Cardiol 1998;81:1072–7

    Article  CAS  PubMed  Google Scholar 

  5. Di Carli MF, Davidson M, Little R, Khanna S, Mody FV, Brunken RC, Czernin J, Rokhsar S, Stevenson LW, Laks H. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol 1994;73:527–33

    Article  PubMed  Google Scholar 

  6. Tamaki N, Tadamura E, Kudoh T, Hattori N, Yonekura Y, Nohara R, Sasayama S, Ikebukuro K, Kato H, Konishi J. Prognostic value of iodine-123 labeled BMIPP fatty acid analogue imaging in patients with myocardial infarction. Eur J Nucl Med 1996;23:272–9

    CAS  PubMed  Google Scholar 

  7. Nakata T, Kobayashi T, Tamaki N, Kobayashi T, Wakabayashi S, Shimoshige K, Oh-hori K, Hamabe K, Hirasawa T, Matsuki T, Shogase M, Furudate M, Shimanoto K. Prognostic value of impaired myocardial fatty acid uptake in patients with acute myocardial infarction. Nucl Med Commun 2000;21:897–906

    Article  CAS  PubMed  Google Scholar 

  8. Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. J Nucl Cardiol 2002;9:240–5

    Article  PubMed  Google Scholar 

  9. Wynne J, Green JH, Mann T, Levin D, Grossman W. Estimation of left ventricular volumes in man from biplane cineangiograms filmed in oblique projections. Am J Cardiol 1978;41:726–32

    Article  CAS  PubMed  Google Scholar 

  10. Gibson RS, Watson DD, Craddock GB, Crampton RS, Kaiser DL, Denny MJ, Beller GA. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. Circulation 1983;68:321–36

    CAS  PubMed  Google Scholar 

  11. Brown KA, Weiss RM, Clements JP, Wackers FJ. Usefulness of residual ischemic myocardium within prior infarct zone for identifying patients at high risk late after acute myocardial infarction. Am J Cardiol 1987;60:15–9

    Article  CAS  PubMed  Google Scholar 

  12. Kropp J, Eisenhur M, Ambrose KR, Knapp FF, Franke WG. Pharmacokinetics and metabolism of the methyl-branched fatty acid (BMIPP) in animals and humans. J Nucl Med 1999;40:1484–91

    CAS  PubMed  Google Scholar 

  13. Hosokawa R, Nohara R, Fujibayashi Y, Okuda K, Ogino M, Hata T, Fujita M, Tamaki N, Konishi J, Sasayama S. Myocardial kinetics of iodine-123-BMIPP in canine myocardium after regional ischemia and reperfusion: implications for clinical SPECT. J Nucl Med 1997;38:1857–63

    CAS  PubMed  Google Scholar 

  14. Fujiwara S, Takeishi Y, Atsumi H, Yamaki M, Takahashi N, Yamaoka M, Tojo T, Tomoike H. Prediction of functional recovery in acute myocardial infarction: comparison between sestamibi reverse redistribution and sestamibi/BMIPP mismatch. J Nucl Cardiol 1998;5:119–27

    Article  CAS  PubMed  Google Scholar 

  15. Marwick TH, Maclntyre WJ, Lafont A, Nemec JJ, Scalcedo EE. Metabolic response of hibernating and infarcted myocardium to revascularization. A follow-up study of regional perfusion, function and metabolism. Circulation 1992;85:1347–53

    CAS  PubMed  Google Scholar 

  16. Tanaka R, Nakamuta T. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction. J Nucl Med 2001;42:1351–8

    CAS  PubMed  Google Scholar 

  17. Mochizuki T, Murase K, Higashino H, Miyagawa M, Sugawara Y, Kikuchi T, Ikezoe J. Ischemic “memory image” in acute myocardial infarction of 123I-BMIPP after reperfusion therapy: a comparison with 99mTc-pyrophosphate and 201Tl dual-isotope SPECT. Ann Nucl Med 2002;16:563–8

    PubMed  Google Scholar 

  18. Nohara R, Okuda K, Ogino M, Hosokawa R, Tamaki N, Konishi J, Fujibayashi Y, Yonekura Y, Fujita M, Sasayama S. Evaluation of myocardial viability with iodine-123-BMIPP in a canine model. J Nucl Med 1996;37:1403–7

    CAS  PubMed  Google Scholar 

  19. Hashimoto A, Nakata T, Tsuchihashi K, Tanaka S, Fujimori K, Iimura O. Post ischemic functional recovery and BMIPP uptake after primary percutaneous transluminal coronary angioplasty in acute myocardial infarction. Am J Cardiol 1996;77:25–30

    Article  CAS  PubMed  Google Scholar 

  20. Hambye AS, Vervaet A, Dobbeleir A, Dendale P, Franken P. Prediction of functional outcome by quantification of sestamibi and BMIPP after acute myocardial infarction. Eur J Nucl Med 2000;27:1494–500

    Article  CAS  PubMed  Google Scholar 

  21. Nakajima K, Shimizu K, Taki J, Uetani Y, Konishi S, Tonami N, Hisada K. Utility of iodine-123-BMIPP in the diagnosis and follow-up of vasospastic angina. J Nucl Med 1995;36:1934–40

    CAS  PubMed  Google Scholar 

  22. Takeishi Y, Sukekawa H, Saito H, Nisihmura S, Shibu T, Sasaki Y, Tomoike H. Clinical significance of decreased myocardial uptake of 123I-BMIPP in patients with stable angina pectoris. Nucl Med Commun 1995;16:1002–8

    CAS  PubMed  Google Scholar 

  23. Kudoh E, Tadamura E, Tamaki N, Hattori N, Inubushi M, Kubo S, Magata Y, Nishimura K, Matsuda K, Konishi J. Iodinated free fatty acid and 201Tl uptake in chronically hypoperfused myocardium: histologic correlation study. J Nucl Med 2000;41:293–6

    CAS  PubMed  Google Scholar 

  24. Franken PR, Geeter FD, Dendale P, Demoor D, Block P, Bossuyt A. Abnormal fatty acid uptake in subacute myocardial infarction after coronary thrombosis: correlation with wall motion and inotropic reserve. J Nucl Med 1994;35:1758–65

    CAS  PubMed  Google Scholar 

  25. Dendale P, Franken PR, van der Wall EE, de Roos A. Wall thickening at rest and contractile reserve early after myocardial infarction: correlation with myocardial perfusion and metabolism. Coron Artery Dis 1997;8;259–64

    Google Scholar 

  26. Tamaki N, Tadamura E, Kawamoto M, Magata Y, Yonekura Y, Fujibayashi Y, Nohara R, Sasayama S, Konishi J. Decreased uptake of iodinated branched fatty acid analog indicates metabolic alterations in ischemic myocardium. J Nucl Med 1995;36:1974–80

    CAS  PubMed  Google Scholar 

  27. Tamaki N, Kawamoto M, Tadamura E, Magata Y, Yonekura Y, Nohara R, Sasayama S, Nishimura K, Ban T, Konishi J. Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography. Circulation 1995;91:1697–705

    CAS  PubMed  Google Scholar 

  28. Schöder H, Campisi R, Ohtake T, Hoh CK, Moon DH, Czernin J, Schelbert HR. Blood flow-metabolism imaging with positron emission tomography in patients with diabetes mellitus for the assessment of reversible left ventricular contractile dysfunction. J Am Coll Cardiol 1999;33:1328–37

    Article  PubMed  Google Scholar 

  29. Taniguchi J, Noma A, Irisawa H. Modification of cardiac action potential by intracellular injection of adenosine triphosphate and related substances in guinea pig single ventricular cells. Circ Res 1983;53:131–9

    CAS  PubMed  Google Scholar 

  30. Fujibayashi Y, Yonekura Y, Takemura Y, Wada K, Matsumoto K, Tamaki N, Yamamoto K, Konishi J, Yokoyama A. Myocardial accumulation of iodinated beta-methyl-branched fatty acid analogue, iodine-125-15-(p-iodophenyl)-3-(R,S) methylpentadecanoic acid (BMIPP), in relation to ATP concentration. J Nucl Med 1990;31:1818–22

    CAS  PubMed  Google Scholar 

  31. Grines CL, Cox DA, Stone GW, Garcia E, Mattos LA, Giambartolomei A, Brodie BR, Madonna O, Eijgelshoven M, Lansky AJ, O’Neill WW, Morice MC. Coronary angioplasty with or without stent implantation for acute myocardial infarction. N Engl J Med 1999;341:1949–56

    Article  CAS  PubMed  Google Scholar 

  32. Montalescot G, Barragan P, Wittenberg O, Ecollan P, Elhadad S, Villain P, Boulenc JM, Morice MC, Maillard L, Pansiri M, Choussat R, Pinton P. Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction. N Engl J Med 2001;344:1895–903

    Article  CAS  PubMed  Google Scholar 

  33. Petronio AS, Rovai D, Musumeci G, Baglini R, Nardi C, Limbruno U, Palagi C, Volterrani D, Mariani M. Effects of abciximab on microvascular integrity and left ventricular functional recovery in patients with acute myocardial infarction treated by primary coronary angioplasty. Eur Heart J 2003;24:67–76

    Article  CAS  PubMed  Google Scholar 

  34. Ito H, Taniyama Y, Iwakura K, Nishikawa N, Masuyama T, Kuzuya T, Hori M, Higashino Y, Fujii K, Minamino T. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 1999;33:654–60

    Article  CAS  PubMed  Google Scholar 

  35. Fukuzawa S, Ozawa S, Inagaki M, Shimada K, Sugioka J, Tateno K, Ueda M. Nicorandil affords cardiac protection in patients with acute myocardial infarction treated with primary PTCA: assessment with thallium-201/iodine-123 BMIPP dual SPECT. J Nucl Cardiol 2000;7:447–53

    Article  CAS  PubMed  Google Scholar 

  36. Lenderink T, Simoons ML, Van Es G-A, Van de Werf F, Verstraete M, Arnold AE. Benefit of thrombolytic therapy is sustained throughout five years and is related to TIMI perfusion grade 3 but not grade 2 flow at discharge. Circulation 1995;92:1110–6

    CAS  PubMed  Google Scholar 

  37. Late Study Group. Late assessment of thrombolytic efficacy (LATE) study with alteplase 6–24 hours after onset of acute myocardial infarction. Lancet 1993;342:759–66

    Article  PubMed  Google Scholar 

  38. Mahmarian JJ, Mahmarian AC, Marks GF, Pratt CM, Verani MS. Role of adenosine thallium-201 tomography for defining long-term risk in patients after acute myocardial infarction. J Am Coll Cardiol 1995;25:1333–40

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors thank Mitsuo Sugimoto, RT, and Ken-ichi Kamegai, RT, at the Nagoya Daini Red Cross Hospital for their technical assistance and interesting suggestions.

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Authors and Affiliations

  1. Cardiovascular Center, Nagoya Daini Red Cross Hospital, 2-9 Myouken-cho, Showa, Nagoya, 466-8650, Japan

    Mamoru Nanasato & Haruo Hirayama

  2. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Akitada Ando, Satoshi Isobe, Makoto Nonokawa & Toyoaki Murohara

  3. Department of Radiology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Yoshimi Kinoshita & Ichiro Nanbu

  4. Cardiovascular Division, Department of Clinical Pathophysiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Mitsuhiro Yokota

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  1. Mamoru Nanasato
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Correspondence to Mamoru Nanasato.

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Nanasato, M., Hirayama, H., Ando, A. et al. Incremental predictive value of myocardial scintigraphy with 123I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Eur J Nucl Med Mol Imaging 31, 1512–1521 (2004). https://doi.org/10.1007/s00259-004-1556-3

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  • DOI: https://doi.org/10.1007/s00259-004-1556-3

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