A dynamic change by I-123-15-(p-iodophenyl)-3-R,S-methyl pentadecanoic acid myocardial single photon emission computed tomography in a 55-year-old woman

A 55-year-old woman was admitted to hospital with chest discomfort. Emergen cy angiography revealed no organic stenosis in the coronary artery, but the re was akinesis in the apico-anteroseptal region of the left ventricle, Lef t ventriculography on the 5th day after admission was normal. On the 2nd da y, initial imaging by I-123-15-(p-iodophenyl)-3-R,S-methylpentadecanoic aci d (BMIPP) myocardial single photon emission computed tomography (SPECT) ind icated a slight decrease in tracer uptake and delayed imaging revealed fill -in in the apico-anteroseptal regions in spite of akinesis in those areas. On the 4th day, initial imaging by I-123-BMIPP showed a moderate decrease i n tracer uptake and delayed imaging revealed a high washout again in those areas. On the 12th day, initial imaging by I-123-BMIPP showed a severely re duced uptake in the apico-anteroseptal regions and delayed imaging disclose d a high washout, in the same areas that showed akinesis during the acute p hase. On the 35th day,I-123-BMIPP identified no significant decrease in tra cer uptake. It is suggested that these dynamic changes in I-123-BMIPP myoca rdial SPECT imaging may reflect the metabolic change of fatty acid in the i schemic state, the size and degree of turnover of the triacylglycerol pool.