EVALUATION OF MYOCARDIAL PERFUSION AND FATTY-ACID UPTAKE USING A SINGLE INJECTION OF IODINE-123-BMIPP IN PATIENTS WITH ACUTE CORONARY SYNDROMES

The purpose of this study was to clarify the possibility of simultaneo us evaluation of myocardial perfusion and fatty acid metabolism using a single injection of I-123-beta-methyl-p-iodophenyl-pentadecanoic aci d (BMIPP) in patients with acute coronary syndromes, Methods: Thirty p atients with unstable angina pectoris (UAP group) and 15 patients with acute myocardial infarction (MI group) were studied. BMIPP dynamic SP ECT was performed 2 min after the injection of BMIPP (185 MBq), and im ages were obtained every 3 min for 15 min with a three-head gamma came ra. Conventional BMIPP SPECT was also performed 30 min after the injec tion. Serial BMIPP and resting Tl-201 images were compared. Results: A Tl-201-BMIPP mismatch between 30-min BMIPP and resting Tl-201 images was observed in 27 of 30 patients in the UAP group and 8 of 15 patient s in the MI group, respectively. However, a Tl-201-BMIPP mismatch betw een early (2-5-min) BMIPP and resting Tl-201 images was observed in on ly 2 of 30 patients in the UAP group and in only 2 of 15 patients in t he MI group, respectively. The kappa statistics of tracer uptake betwe en early BMIPP and resting Tl-201 images showed good concordance in UA P (kappa = 0.823) and MI (kappa = 0.765) groups, respectively. These r esults indicated that initial distribution of BMIPP reflects myocardia l perfusion in patients with acute coronary syndromes. Conclusion: Myo cardial perfusion and fatty acid metabolism can be evaluated simultane ously using a single injection of BMIPP, when images are taken soon (2 -5 min) and long after the injection in patients with acute coronary s yndromes.