A CASE OF HYPERTENSIVE-DIABETIC CARDIOMYOPATHY DEMONSTRATING LEFT-VENTRICULAR WALL-MOTION ABNORMALITY

We report a case of hypertensive-diabetic cardiomyopathy demonstrating left ventricular regional wall motion abnormality, with a normal coro nary artery documented on coronary arteriography. Dipyridamole-infusio n Tl-201 scintigraphy demonstrated transient perfusion defects in the infero-posterior wall of the left ventricle, where reduced wall motion was demonstrated on contrast left ventriculography. Myocardial SPECT (single photon emission tomography) imaging with [I-123]beta-methyliod ophenylpentadecanoic acid (BMIPP) and Tl-201 demonstrated reduced[I-12 3]BMIPP uptake compared with Tl-201 uptake in the infero-posterior wal l of left ventricle. These results suggest that the impairement of myo cardial free fatty acid metabolism is an etiologic or contributory fac tor for regional wall motion abnormality, together with small-vessel c oronary artery disease, in this patient.