H Kageyama, K Morita, C Katoh, T Tsukamoto, K Noriyasu, M Mabuchi, M Naya, Y Kawai, N Tamaki
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 33 (1) 6 - 12 1619-7070 2006/01
[Refereed][Not invited] Purpose: Long-chain fatty acid (LCFA) is the main energy source for normal myocardium at rest, but in ischemic myocardium, the main energy substrate shifts from LCFA to glucose. I-123\-BMIPP is a radiolabeled LCFA analog. In chronic stable angina without previous infarction, we suppose that reduced I-123\-BMIPP uptake is related to the substrate shift in myocardium with decreased myocardial flow reserve (MFR). The purpose of this study was to relate I-123-BMIPP uptake to rest myocardial blood flow (MBF), hyperemic MBF, and MFR assessed with O-15-water positron emission tomography ( PET).
Methods: We enrolled 21 patients with chronic stable angina without previous infarction, all of whom underwent I-123-BMIPP single-photon emission computed tomography (SPECT) and O-15-water PET. The left ventricle was divided into 13 segments. In each segment, rest MBF and hyperemic MBF were measured by PET. I-123-BMIPP uptake was evaluated as follows: score 0= normal, 1= slightly decreased uptake, 2= moderately decreased uptake, 3= severely decreased uptake, and 4= complete defect. I-123\-BMIPP uptake was compared with rest MBF, hyperemic MBF, and MFR.
Results: The numbers of segments with I-123-BMIPP scores 0, 1, 2, 3, and 4 were 178, 40, 25, 24, and 0, respectively. The rest MBFs for scores 0, 1, 2, and 3 were 0.93 +/- 0.25, 0.86 +/- 0.21, 0.97 +/- 0.30, and 0.99 +/- 0.37 ml/min/g, respectively. The hyperemic MBFs for scores 0, 1, 2, and 3 were 2.76 +/- 1.29, 1.84 +/- 0.74, 1.37 +/- 0.39, and 1.08 +/-= 0.40 ml/min/g, respectively. The MFRs for scores 0, 1, 2, and 3 were 3.01 +/- 1.38, 2.20 +/- 0.95, 1.44 +/- 0.22, and 1.10 +/- 0.26, respectively. As I-123-BMIPP uptake declined, hyperemic MBF and MFR decreased.
Conclusion: In chronic stable angina without previous infarction, reduced I-123-BMIPP uptake implies decreased MFR.