Increasing myocardial123I-BMIPP uptake in non-ischemic area in a patient with acute myocardial ischemia

The subject was a 65-year-old woman with chest pain. An electrocardiogram revealed T-wave-inversion in leads III, aV^sub F^, V^sub 1^-V^sub 5^.^sup 99m^Tc-tetrofosmin myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex. These findings suggested acute myocardial ischem...

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Published inAnnals of nuclear medicine Vol. 16; no. 8; pp. 573 - 576
Main Authors Nishikawa, Susumu, Ito, Kazuki, Takada, Hiroki, Tsubakimoto, Yoshinori, Yuba, Tatsuya, Adachi, Yoshihiko, Kato, Syuji, Azuma, Akihiro, Sugihara, Hiroki, Nakagawa, Masao
Format Journal Article
LanguageEnglish
Published Tokyo Springer Nature B.V 01.12.2002
Subjects
Angiography
Chemotherapy
Drug therapy
EKG
Electrocardiography
Fatty acids
Flow velocity
Ischemia
Medical imaging
Metabolism
Myocardial ischemia
Oxidation
Single photon emission computed tomography
Ticlopidine
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Summary:The subject was a 65-year-old woman with chest pain. An electrocardiogram revealed T-wave-inversion in leads III, aV^sub F^, V^sub 1^-V^sub 5^.^sup 99m^Tc-tetrofosmin myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex. These findings suggested acute myocardial ischemia. Coronary angiography did not show any stenotic lesions, but diffuse coronary ectasia was noted in three vessels. Coronary flow velocity was remarkably reduced on coronary angiography. Epicardial coronary spasm was not provoked by ergonovine loading test. Left ventriculography showed diffuse hypokinesis.^sup 123^I-BMIPP myocardial SPECT showed mildly reduced uptake in the anteroseptal wall and the apex on the early images. But 4-hour delayed images showed an increase of 8% in myocardial^sup 123^I-BMIPP uptake. We treated this patient with ticlopidine and nicorandil. After drug therapy her symptoms and left ventriculography improved.^sup 123^I-BMIPP myocardial SPECT findings on the early images improved, whereas delayed images showed a decrease of 28% in myocardial^sup 123^I-BMIPP uptake after two weeks and 36% after four weeks. These dynamic changes in^sup 123^I-BMIPP findings might be a reflection of myocardial fatty acid metabolism in patients with acute myocardial ischemia. Delayed^sup 123^I-BMIPP myocardial SPECT images are useful for the assessment of fatty acid metabolism.[PUBLICATION ABSTRACT]
ISSN:0914-7187
1864-6433
DOI:10.1007/BF02988636