Use of [I-123]-BMIPP myocardial scintigraphy for the clinical evaluation of a fatty-acid metabolism disorder of the right ventricle in chronic respiratory and pulmonary vascular disease

The objective of this study was to evaluate whether or not right ventricle (RV) uptake of iodine-123-labelled-beta-methyliodo-phenylpentadecanoic acid ([I-123]-BMIPP) correlated with the degree of right ventricular pressure o verload (RVPO). Myocardial scintigraphy of [I-123]-BMIPP and thallium-201 ( Tl-201) was performed on 46 patients with RVPO. We determined the right ven tricle (RV)/left ventricle (LV) ratio = (radioactivities of RV)/(radioactiv ities of LV), and the RV metabolic index (RVMI) = (RV/LV ratio of [I-123]-B MIPP)/(RV/LV ratio of Tl-201). We also evaluated the correlation between RV MI and mean pulmonary arterial pressure (mPAP), and between RVMI and total pulmonary resistance (TPR). Significant correlations were found between the RV/LV ratio of [I-123]-BMIPP and mPAP and between the RV/LV ratio of [I-12 3]-BMIPP and TPR. In addition, a significant negative correlation was obser ved between RVMI and mPAP and between RVMI and TPR. RVMI declined as RVPO i ncreased, suggesting the presence of a fatty-acid metabolism disorder of th e RV. Moreover, [I-123]-BMIPP myocardial scintigraphy could be useful for e valuating a disorder of the fatty-acid metabolism of the RV with RVPO.