Usefulness of I-123-BMIPP with myocardial imaging for evaluation of the efficacy of drug therapy in patients with chronic heart failure

Background: Fatty acid is a main source of cardiac energy in aerobic condit ions. We used iodine-123-beta -methyl-iodophenyl pentadecanoic acid (I-123- BMIPP) myocardial scintigraphy to study the efficacy of the angiotensin-con verting enzyme inhibitor (ACEI) enalapril in the treatment of chronic heart failure (CHF) by evaluating its therapeutic effects on myocardial fatty ac id metabolism. Methods and Results: New York Heart Association functional class status, le ft ventricular end-diastolic diameter, percent fractional shortening, the r atio between early and late peaks of flow Velocity, I-123-BMIPP myocardial- to-mediastinal uptake ratio, and mean washout rate were measured in 42 pati ents (31 men and I I women; mean age, 58 +/- 3 years) with CHF before treat ment and 3 months after treatment. There was a significant correlation betw een myocardial fatty acid metabolism and other variables as well as between the degree of improvement in myocardial fatty acid metabolism and the degr ee of improvement in other variables. Conclusions: Enalapril improved symptoms and cardiac function in patients w ith CHF. These improvements significantly correlated with improvement of I- 123-BMIPP metabolism in the myocardium. I-123-BMIPP scintigraphy is useful for evaluating the efficacy of drug therapy for CHF based on myocardial fat ty acid metabolism.