Background. Iodine 123-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoi
c acid (BMIPP) is mainly trapped in the myocardium as triglyceride, dependi
ng on the adenosine triphosphate level. Ten percent to 20% of it is metabol
ized through alpha -oxidation after beta -oxidation; however, the precise m
echanism of the regulatory pathways of BMIPP is yet to be clarified.
Methods and Results. A brief left coronary artery occlusion (10-30 minutes)
was performed in 28 male Wistar-Kyoto rats. Dual single photon emission co
mputed tomography images of BMIPP and thallium 201 were obtained 3 days and
24 days after the operation. The activities of 3-hydroxyacyl-coenzyme A de
hydrogenase (HAD), citrate synthase (CS), and alpha -glycerol-phosphate deh
ydrogenase (GPD) were then measured in both ischemic and nonischemic region
s. BMIPP and TI-201 chloride severity scores were also evaluated convention
ally. CS and HAD levels were significantly lower in the ischemic region tha
n in the nonischemic region in the chronic group (CS, 102.9 +/- 28.1 vs 138
.7 +/- 33.7 mu mol/g/min, respectively, P = .0051; HAD, 54.7 +/- 20.1 vs 78
.6 +/- 18.7 mu mol/g/min, respectively, P = .0031). There was no difference
in GPD between the ischemic and nonischemic regions. The BMIPP severity sc
ore had closer inverse relations with HAD (acute, r = -0.82; chronic, r = -
0.80) and CS (acute, r = -0.87; chronic, r = -0.81), but not with GPD, than
did TI-201 chloride severity score.
Conclusions. BMIPP imaging correlates well with the activities of HAD and C
S, suggesting that a decrease in BMIPP uptake reflects deterioration of bot
h fatty acid metabolism and citrate cycle and shows information other than
regional myocardial perfusion.