Skip to main content
SpringerLink
Log in

Future aspects of BMIPP

  • Published:
The International Journal of Cardiac Imaging Aims and scope Submit manuscript

Abstract

Iodinated fatty acid compounds have an important role in early detection of myocardial abnormalities and provide insights into pathological states in the heart. Among them, 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid (BMIPP) has been most widely used providing excellent images of the left ventricular myocardium due to high myocardial uptake and long retention. The previous chapters have focused on the basic characters and clinical applications of this compound. However, the precise mechanisms of myocardial kinetics should be further investigated under various conditions. Most of the studies showed reduced BMIPP uptake relative to perfusion in a variety of myocardial disorders, whereas an increase in BMIPP uptake relative to perfusion is often reported. The potential mechanisms of such conflicting results are discussed, but basic studies should be performed to clarify such results in detail. There are a number of clinical values of this compound. Since alteration of fatty acid is observed in the repetitive ischemia, BMIPP can be used for detecting severe ischemic episodes. The concept of ‘ischemic memory’ imaging can be applied for patients with unstable or vasospastic angina at rest and for those with acute myocardial infarction with successful revascularization to identify the risk area. The discordant decrease in BMIPP uptake relative to perfusion is often seen in ischemic but viable myocardium, and therefore, the combined imaging of BMIPP and perfusion can be used for assessment of tissue viability. Furthermore, abnormal BMIPP uptake is most often observed in hypertrophic cardiomyopathy, and thus, this compound can be used for an early detection and differential diagnosis of the cardiomyopathy. Although BMIPP imaging seems to be quite promising in many fields, the number of patient data remain limited. In this respect, a multicenter study with a vast majority of patients is warranted to confirm these important values of BMIPP. In addition, this attractive tracer should be available all over the world to confirm its clinical value in the near future.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Knapp FF Jr, Kropp J. Iodine-123-labelled fatty acids for myocardail single-photon emission tomography: current status and future perspectives. Eur J Nucl Med 1995; 22: 361-381.

    Google Scholar 

  2. Machulla HJ, Marsmann M, Dutschka K. Biochemical synthesis of a radioiodinated phenyl fatty acid for in vivo metabolic studies of the myocardium. Eur J Nucl Med 1980; 5: 171-173.

    Google Scholar 

  3. Tamaki N, Kawamoto M. The use of iodinated free fatty acids for assessing fatty acid metabolism. J Nucl Cardiol 1994; 1: S72-78.

    Google Scholar 

  4. Tamaki N, Fujibayashi Y, Magata Y, et al. Radionuclide assessment of myocardial fatty acid metabolism by PET and SPECT. J Nucl Cardiol 1995; 2: 256-266.

    Google Scholar 

  5. Fujibayashi Y, Nohara R, Hosokawa R, et al. Metabolism and kinetics of iodine-123-BMIPP in canine myocardium. J Nucl Med 1996; 37: 757-761.

    Google Scholar 

  6. Morishita S, Kusuoka H, Yamamichi Y, et al. Kinetics of radioiodinated species in subcellular fractions from rat hearts following administration of iodine-123-labelled 15-(piodophenyl)-3-(R,S) methylpentadecanoic acid (123I-BMIPP). Eur J Nucl Med 1996; 23: 383-389.

    Google Scholar 

  7. Yamamichi Y, Kusuoka H, Morishita K, et al. Metabolism of 123I-labeled 15-p-iodophenyl-3-(R,S)-methyl-pentadecanoic acid (BMIPP) in perfused rat heart. J Nucl Med 1995; 36: 1043-1050.

    Google Scholar 

  8. Hosokawa R, Nohara R, Fujibayashi Y, et al. Metabolic fate of iodine-123-BMIPP in canine myocardium after administration of etomoxir. J Nucl Med 1996; 37: 1836-1840

    Google Scholar 

  9. Matsunari I, Saga T, Taki J, et al. Kinetics of iodine-123-BMIPP in patients with prior myocardial infarction: assessment with dynamic rest and stress images compared with stress thallium-201 SPECT. J Nucl Med 1994; 35: 1279-1285.

    Google Scholar 

  10. Kobayashi H, Kusakabe K, Momose M, et al. Evaluation of myocardial perfusion and fatty acid uptake using a single injection of iodine-123-BMIPP in patients with acute coronary syndrome. J Nucl Med 1998; 39: 1117-1122.

    Google Scholar 

  11. Fujibayashi Y, Yonekura Y, Takemura Y, et al. 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: 1818-1822.

    Google Scholar 

  12. Fujibayashi Y. Yonekura Y, Tamaki N, et al. Myocardial accumulation of BMIPP in relation to ATP concentration. Ann Nucl Med 1993; 7: 15-18.

    Google Scholar 

  13. Nohara R, Okuda K, Ogino M, et al. Evaluation of myocardial viability with iodine-123-BMIPP in a canine model. J Nucl Med 1996; 37: 1403-1407.

    Google Scholar 

  14. Schelbert HR, Henze E, Sochor H, et al. Effects of substrate availability on myocardial C-11 palmitate kinetics by positron emission tomography in normal subjects and patients with ventricular dysfunction. Am Heart J 1986; 111: 1055-1064.

    Google Scholar 

  15. Takeda K, Saito K, Makino K, et al. iodine-123-BMIPP myocardial washout and cardiac workload during exercise in normal and ischmeic hearts. J Nucl Med 1997; 38: 559-563.

    Google Scholar 

  16. Reinhardt CP, Weinstein H, Marcel R, et al. Comparison of iodine-125-BMIPP and thallium-201 in myocardial hypoperfusion. J Nucl Med 1995; 36: 1645-1653.

    Google Scholar 

  17. Kawamoto M, Tamaki, N, Yonekura Y, et al. Significance of myocardial uptake of iodine-123-labeled beta-methyl iodophenyl pentadecanoic acid: comparison with kinetics of carbon 11-labeled palmitate in positron emission tomography. J Nucl Cardiol 1994; 1: 522-528.

    Google Scholar 

  18. Tamaki N, Tadamura E, Kawamoto M, et al. Decreased uptake of iodinated branched fatty acid analog indicates metabolic alterations in ischemic myocardium. J Nucl Med 1995; 36: 1974-1980.

    Google Scholar 

  19. Sloof GW, Visser FC, Bax JJ, et al. Increased uptake of iodine-123-BMIPP in chronic ischemic heart disease: comparison with fluorine-18-FDG SPECT. J Nucl Med 1998; 39: 255-260.

    Google Scholar 

  20. Miller DD, Gill JB, Livni E, et al. Fatty acid analogue accumulation: a marker of myocyte viability in ischemic-reperfused myocardium. Circ Res 1988; 63: 681-693.

    Google Scholar 

  21. Nishimura T, Sago M, Kihara K, et al. Fatty acid myocardial imaging using 123I-β-methyl-iodophenyl pentadecanoic aicd (BMIPP): comparison of myocardial perfusion and fatty acid utilization in canine myocardial infarction (occlusion and reperfusion model). Eur J Nucl Med 1989; 15: 341-345.

    Google Scholar 

  22. Weiss ES, Hoffman EJ, Phelps ME, Welch MJ, Henry PD, Ter-Pogossian MM, Sobel BE. External detection and visualization of myocardial ischemia with C-11 substrates in vivo and in vitro. Circ Res 1976; 39: 24-32.

    Google Scholar 

  23. Hosokawa R, Nohara R, Fujibayashi Y, et al. Myocardial kinetics of iodine-123-BMIPP in canine myocardium after regional ischemia and reperfusion: implications for clincial SPECT. J Nucl Med 1997; 38: 1857-1863.

    Google Scholar 

  24. Kudoh T, Tamaki N, Magata Y, et al. Metablism substrate with negative myocardial uptake of iodine-123-BMIPP. J Nucl Med 1997; 38: 548-553.

    Google Scholar 

  25. Kurata C, Wakabayashi Y, Shouda S, et al. Influence of blood substrate levels on myocardial kinetics of iodine-123-BMIPP. J Nucl Med 1997; 38: 1079-1084.

    Google Scholar 

  26. Hwang E, Yamashita A, Takemori H, et al. Absent myocardial I-123 BMIPP uptake in a family. Annals Nucl Med 1996; 10: 445-448.

    Google Scholar 

  27. Tanaka T, Kawamura K. Isolation of myocardial membrane long-chain fatty acid-binding protein: homology with a rat long-chain fatty acids. J Mol Cell Cardiol 1995; 27: 1613-1622.

    Google Scholar 

  28. Kurata C, Kobayashi A, Yamazaki N, et al. Dual tracer autoradiographic study with thallium-201 and radioiodinated fatty acid in cardiomyopathy hamsters. J Nucl Med 1989; 30: 80-87.

    Google Scholar 

  29. Nakai K, Ahmad M, Nakaki M, et al. Serial course of the left ventricular function, perfusion and radioiodinated fatty acid cardiomyopathic hamster. J Nucl Med 1993; 34: 1309-1315.

    Google Scholar 

  30. Vyska M, Machulla H, Stremmel W, et al. Regional myocardial free fatty acid extraction in normal and ischmeic myocardium. Circulation 1988; 78: 1218-1233.

    Google Scholar 

  31. Takeishi Y, Sukekawa H, Saito H, et al. Impaired myocardial fatty acid metabolism detected by 123I-BMIPP in patients with unstable angina pectoris: comparison with perfusion imaging by 99mTc-sestamibi. Ann Nucl Med 1995; 9: 125-130.

    Google Scholar 

  32. Takeishi Y, Sukekawa H, Saito H, et al. Clinical significance of decreased myocardial uptake of 123I-BMIPP in patients with stable effort angina pectoris. Nucl Med Commun 1995; 16: 1002-1008.

    Google Scholar 

  33. Nakajima K, Schimizu K, Taki J, et al. Utility of iodine-123-BMIPP in the diagnosis and follow-up of vasospastic angina. J Nucl Med 1995; 36: 1934-1940.

    Google Scholar 

  34. Tateno M, Tamaki N, Kudoh T, et al. Assessment of fatty acid uptake in patients with ischmeic heart disease without myocardial infarction. J Nucl Med 1996; 37: 1981-1985.

    Google Scholar 

  35. Takeishi Y, Fujiwara S, Atsumi H, et al. Iodine-123-BMIPP imaging in unstable angina: a guide for interventional therapy. J Nucl Med 1997; 38: 1407-1411.

    Google Scholar 

  36. Yoshida S, Ito M, Mitsunami K, Kinoshita M. Improved myocardial fatty acid metabolism after coronary angioplasty in chronic coronary artery disease. J Nucl Med 1998; 39: 933-938.

    Google Scholar 

  37. Tamaki N, Kawamoto M, Yonekura Y, Fujibayashi Y, Takahashi N, Konishi J, Nohara R, Kambara H, Kawai C, Ikekubo K, Kato H. Regional metabolic abnormality in relation to perfusion and wall motion in patients with myocadial infarction: assessment with emission tomography using an iodonated branched fatty acid. J Nucl Med 1992, 33: 659-667.

    Google Scholar 

  38. DeGeeter F, Franken P, Knapp FF Jr, et al. Relationship between blood flow and fatty acid metabolism in subacute myocardial infarction: a study by means of Tc-99m sestamibi and iodine-123-beta-methyl iodophenyl pentadecanoic acid. Eur J Nucl Med 1994; 21: 283-291.

    Google Scholar 

  39. Franken P, DeGeeter F, Dendale P, et al. Abnormal free fatty acid uptake in subacute myocardial infarction after coronary thrombolysis: correlation with wall motion and inotropic reserve. J Nucl Med 1994; 35: 1758-1765

    Google Scholar 

  40. Matsunari I, Saga T, Taki J, et al. Improved myocardial fatty acid utilization after percutaneous transmural coronary angioplasty. J Nucl Med 1995; 36: 1605-1607.

    Google Scholar 

  41. Tamaki N, Tadamura E, Kudoh T, et al. Recent advances in nuclear cardiology in the study of coronary artery disease. Ann Nucl Med 1997; 11: 55-66.

    Google Scholar 

  42. Taki J, Nakajima K, Matsunari I, et al. Impairment of regional fatty acid uptake in relation to wall motion and thallium-201 uptake in ischemic but viable myocardium. Eur J Nucl Med 1995, 22: 1385-1392.

    Google Scholar 

  43. Taki J, Nakajima K, Matsunari I, et al. Assessment of improvement of myocardial fatty acid uptake and function after revascularization using iodine-123-BMIPP. J Nucl Med 1997; 38: 1503-1510.

    Google Scholar 

  44. Tsubokura A, Lee JD, Shimizu H, et al. Recovery of perfusion, glucose utilization and fatty acid utilization in stunned myocardium. J Nucl Med 1997; 38: 1835-1837.

    Google Scholar 

  45. Kawai Y, Tsukamoto E, Nozaki Y, et al. Use of 123I-BMIPP single-photon emission tomography to estimate areas at risk following successful revascularization in patients with acute myocardial infarction. Eur J Nucl Med 1998; 25: 1390-1395.

    Google Scholar 

  46. Furutani Y, Shiigi T, Nakamura Y, et al. Quantification of area at risk in acute myocardial infarction by tomographic imaging. J Nucl Med 1997; 38: 1875-1882.

    Google Scholar 

  47. Kawamoto M, Tamaki N, Yonekura Y, et al. Combined study with I-123 fatty acid and thallium-201 to assess ischemic myocardium. Ann Nucl Med 1994; 8: 47-54.

    Google Scholar 

  48. Franken PR, Dendale P, DeGeeter F, et al. Prediction of functional outcome after myocardial infarction using BMIPP and sestamibi scintigraphy. J Nucl Med 1996; 37: 718-722.

    Google Scholar 

  49. Ito T, Tanouchi J, Kato J, et al. Recovery of impaired left ventricular function in patients with acute myocardial infarction is predicted by thje discordance in defect size on 123I-BMIPP and 201Tl SPECT images. Eur J Nucl Med 1996; 23: 917-923.

    Google Scholar 

  50. Hashimoto A, Nakata T, Tsuchihashi K, et al. Postischemic functional recovery and BMIPP uptake after primary percutaneous transluminal coronary angioplasty in acute myocardial infarction. Am J Cardiol 1996; 77: 25-30.

    Google Scholar 

  51. Tamaki N, Tadamura E, Kudoh T, et al. Prognostic value of iodine-123 labelled BMIPP fatty acid analogue imaging in patients with myocardial infarction. Eur J Nucl Med 1996; 23: 272-279.

    Google Scholar 

  52. Grover-McKay M, Schwaiger M, Krivokapitch J, et al. Regional myocardial blood flow and metabolism at rest in mildly symptomatic patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1989; 13: 317-324.

    Google Scholar 

  53. Tadamura E, Tamaki N, Matsumori A, et al. Myocardial metabolic changes in hypertrophic cardiomyopathy. J Nucl Med 1996; 37: 572-577.

    Google Scholar 

  54. Kurata C, Taniguchi T, Aoshima S, et al. Myocardial emission computed tomography with iodine-123-labeled beta-methyl-branched fatty acid in patients with hypertrophic cardiomyopathy. J Nucl Med 1992; 33: 6-13.

    Google Scholar 

  55. 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 1992; 19: 775-782.

    Google Scholar 

  56. Ohtsuki K, Sugihara H, Umamoto I, et al. Clinical evaluation of hypertrophic cardiomyopathy by myocardial scintigraphy using 123I-labelled 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (123I-BMIPP). Nucl Med Commun 1994; 14: 441-447.

    Google Scholar 

  57. Taki J, Nakajima K, Bunko H, et al. 123I-labelled BMIPP fatty acid myocardial scintigraphy in patients with hypertrophic cardiomyopathy. Nucl Med Commun 1994; 14: 181-188.

    Google Scholar 

  58. Tadamura E, Kudoh T, Tamaki N, et al. Impairment of BMIPP uptake precedes abnormalities in oxygen and glucose metabolism in hypertrophic cardiomyopathy. J Nucl Med 1998; 39: 390-396.

    Google Scholar 

  59. Nishimura T, Nagata S, Uehara T, et al. Prognosis of hypertrophic cardiomyopathy; assessment by 123I-BMIPP myocardial single photon emission computed tomography. Ann Nucl Med 1996; 10: 71-78.

    Google Scholar 

  60. Mochizuki T, Tsukamoto E, Ono T, Itoh K, Kanegae K, et al: Sequential change of BMIPP uptake with age in spontaneously hypertensive rat model. Ann Nucl Med 1997; 11: 299-306.

    Google Scholar 

  61. Ono T, Tsukamoto E, Mochizuki T, et al. Regression of left ventricular hypertrophy improves fatty acid metabolism in hypertensive rats (Abstract). J Nucl Med 1997; 38: 42.

    Google Scholar 

  62. Hashimoto Y, Yamabe H, Yokoyama M, et al. Myocardial defect detected by 123I-BMIPP scintigraphy and left ventricular dysfunction in patients with idiopathic dilated cardiomyopathy. Ann Nucl Med 1996; 10: 225-230.

    Google Scholar 

  63. Kim Y, Goto H, Kobayashi K, et al. Detection of imparied fatty acid metabolism in right ventricular hypertrophy: assessment by 123I β-methyl iodophenyl pentadecanoic acid (BMIPP) myocardial single-photon emission computed tomography. Ann Nucl Med 1997; 11: 207-212.

    Google Scholar 

  64. Kondo C, Nakazawa M, Kusakabe K, et al. Myocardial dysfunction and depressed fatty acid metabolism in patients with cyanotic congenital heart disease. J Nucl Cardiol 1996; 3: 30-36.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, 060, Japan

    Nagara Tamaki, Koichi Morita & Eriko Tsukamoto

  2. Hokko Memorial Hospital, Sapporo, 060, Japan

    Yuko Kawai

Authors
  1. Nagara Tamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koichi Morita
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eriko Tsukamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuko Kawai
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tamaki, N., Morita, K., Tsukamoto, E. et al. Future aspects of BMIPP. Int J Cardiovasc Imaging 15, 79–89 (1999). https://doi.org/10.1023/A:1006109022417

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1006109022417

Search

Navigation