METABOLIC CHANGES IN HIBERNATING MYOCARDIUM AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY AND THE RELATION BETWEEN RECOVERY IN LEFT-VENTRICULAR FUNCTION AND FREE FATTY-ACID METABOLISM

To elucidate the changes in oxidative metabolism in hibernating myocar dium after coronary revascularization, we performed myocardial single- photon emission computed tomography with a free fare acid analog, I-12 3 beta-methyliodophenylpentadecanoic acid (BMIPP), and thallium-201 be fore and 1 month after percutaneous transluminal coronary angioplasty (PTCA) in 11 patients with angina pectoris caused by single artery ste nosis. All patients had improvement in wall motion after PTCA at the r egion with coronary stenosis; the wall motion abnormality score evalua ted by left ventriculography decreased from 5.5 +/- 0.8 (mean +/- SE) to 2.1 +/- 0.9, p < 0.01) after PTCA. The defect score of I-123 BMIPP images was significantly larger than that of thallium-201 images eithe r before (14 +/- 1.3 vs 8.9 +/- 1.1, p < 0.01) or 1 month after (7.4 /- 1.5 vs 3.7 +/- 0.8, p < 0.01) PTCA. The decrease in the defect scor e of both images was significant (p <0.01). Changes in the wall motion abnormality score showed a significant correlation with both the chan ge in the defect score of thallium-201 images (r = 0.58, p <0.01) and that of I-123 BMIPP images (r 0.75, p <0.01). These results indicate t hat the metabolism of free fatty acid is impaired in hibernating myoca rdium, and that improvement in left ventricular function after success ful PTCA is strongly associated with the recovery of oxidative metabol ism. (C) 1998 by Excerpta Medica, Inc.