SIMULTANEOUS DUAL MYOCARDIAL IMAGING WITH IODINE-123-BETA-METHYL IODOPHENYL-PENTADECANOIC ACID (BMIPP) AND TL-201 IN PATIENTS WITH CORONARYHEART-DISEASE

To assess the clinical value of simultaneous dual myocardial imaging w ith iodine-123-beta-methyl-iodophenyl-pentadecanoic acid (I-123-BMIPP) and thallium-201. (Tl-201), myocardial imaging was performed at rest and during exercise in seven patients with coronary heart disease. Whe n I-123-BMIPP and Tl-201 images were compared, the initial exercise an d resting images agreed 87% and 64%, respectively. In the initial rest ing images, the regional uptake of I-123-BMIPP was frequently less tha n that of Tl-201. The incidence of exercise-induced reversible defects by Tl-201 in, the Tl>BMIPP regions was significantly higher than that in the Tl=BMIPP regions (57% vs 4%, p<0.01) and the incidence of coro nary narrowing of more than 90% in the Tl>BMIPP regions was also signi ficantly higher than that in the Tl=BMIPP regions (91% vs 38%, p<0.01) . In addition, this disparity (Tl>BMIPP) was found more frequently in regions with abnormal wall motion than in regions with normal wall mot ion (hypokinetic regions; 68%, severe hypokinetic or akinetic regions; 50%, vs normokinetic regions; 4%, p<0.01). In contrast, the uptake of I-123-BMIPP correlated closely with that of Tl-201 in normal myocardi um and the uptake of both I-123-BMIPP and Tl-201 was severely reduced in myocardium with severe ischemia during exercise and prior infarctio n. These results indicate that dual myocardial imaging with I-123-BMIP P and Tl-201 may provide a unique means of identifying patients with m etabolically disturbed myocardium, such as hibernating and stunned myo cardium.