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Increasing myocardial123I-BMIPP uptake in non-ischemic area in a patient with acute myocardial ischemia

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Abstract

The subject was a 65-year-old woman with chest pain. An electrocardiogram revealed T-wave-inversion in leads III, aVF, V1–V5.99mTc-tetrofosmin myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex. These findings suggested acute myocardial ischemia. Coronary angiography did not show any stenotic lesions, but diffuse coronary ectasia was noted in three vessels. Coronary flow velocity was remarkably reduced on coronary angiography. Epicardial coronary spasm was not provoked by ergonovine loading test. Left ventriculography showed diffuse hypokinesis.123I-BMIPP myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex on the early images. But 4-hour delayed images showed an increase of 8% in myocardial123I-BMIPP uptake. We treated this patient with ticlopidine and nicorandil. After drug therapy her symptoms and left ventriculography improved.123I-BMIPP myocardial SPECT findings on the early images improved, whereas delayed images showed a decrease of 28% in myocardial123I-BMIPP uptake after two weeks and 36% after four weeks. These dynamic changes in123I-BMIPP findings might be a reflection of myocardial fatty acid metabolism in patients with acute myocardial ischemia. Delayed123I-BMIPP myocardial SPECT images are useful for the assessment of fatty acid metabolism.

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Author notes

  1. Susumu Nishikawa

    Present address: Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

Authors and Affiliations

  1. Division of Cardiology, Murakami Memorial Hospital, Asahi University, 3-23 Hashimoto-cho, 500-8523, Gifu, Japan

    Susumu Nishikawa, Kazuki Ito, Hiroki Takada, Yoshinori Tsubakimoto, Tatsuya Yuba, Yoshihiko Adachi & Syuji Kato

  2. Second Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Akihiro Azuma, Hiroki Sugihara & Masao Nakagawa

Authors
  1. Susumu Nishikawa
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  2. Kazuki Ito
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  3. Hiroki Takada
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  4. Yoshinori Tsubakimoto
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  5. Tatsuya Yuba
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  6. Yoshihiko Adachi
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  7. Syuji Kato
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  8. Akihiro Azuma
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  9. Hiroki Sugihara
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  10. Masao Nakagawa
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Nishikawa, S., Ito, K., Takada, H. et al. Increasing myocardial123I-BMIPP uptake in non-ischemic area in a patient with acute myocardial ischemia. Ann Nucl Med 16, 573–576 (2002). https://doi.org/10.1007/BF02988636

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  • DOI: https://doi.org/10.1007/BF02988636

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