Impairment of BMIPP Uptake Precedes Abnormalities in Oxygen and Glucose Metabolism in Hypertrophic Cardiomyopathy

• Published in: The Journal of nuclear medicine (1978) Vol. 39; no. 3; pp. 390 - 396
• Main Authors: Tadamura, Eiji, Kudoh, Takashi, Hattori, Naoya, Inubushi, Masayuki, Magata, Yasuhiro, Konishi, Junji, Matsumori, Akira, Nohara, Ryuji, Sasayama, Shigetake, Yoshibayashi, Muneo, Tamaki, Nagara
• Format: Journal Article
• Language: English
• Published: Reston, VA Soc Nuclear Med 01.03.1998; Society of Nuclear Medicine
• Subjects: Acetates; Adult; Biological and medical sciences; Carbon Radioisotopes; Cardiology. Vascular system; Cardiomyopathy, Hypertrophic - diagnostic imaging; Cardiomyopathy, Hypertrophic - metabolism; Fatty Acids - pharmacokinetics; Female; Fluorine Radioisotopes; Fluorodeoxyglucose F18 - pharmacokinetics; Heart; Heart - diagnostic imaging; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Iodine Radioisotopes; Iodobenzenes - pharmacokinetics; Male; Medical sciences; Myocardium - metabolism; Oxygen Consumption; Radiopharmaceuticals - pharmacokinetics; Thallium Radioisotopes; Tomography, Emission-Computed; Tomography, Emission-Computed, Single-Photon; Radionuclide study; Human; Oxygen; Cardiovascular disease; Clearance; Glucose; Metabolism; Myocardial disease; Heart disease; Distribution; Hypertrophic cardiomyopathy; Technique; Iodine; Positron; Emission tomography
• ISSN: 0161-5505; 1535-5667

Impairment of fatty acid uptake is shown to precede myocardial perfusion abnormality using 123I-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) in an experimental model of hypertrophic cardiomyopathy (HCM) and in human studies. We have recently demonstrated that abnormalities of both glucose and oxidative metabolism precede the reduction of blood flow in HCM. The main purposes of this study were to assess the frequency of abnormal findings in FDG uptake, BMIPP uptake and oxygen metabolism and to clarify the relationship among these metabolic parameters by using PET and SPECT. Twenty-eight subjects with HCM underwent FDG- and acetate-PET and thallium- and BMIPP-SPECT studies at rest, respectively. After correcting for partial volume effect, real percentages of FDG and BMIPP uptake were calculated. In addition, the clearance rate constant (K mono) of acetate was measured and normalized (%) to estimate the oxygen metabolism. There were various metabolic abnormalities observed in patients with HCM. BMIPP uptake was often impaired without significant reduction of K mono values or FDG uptake. Thus, abnormality of BMIPP uptake was more frequently observed than that for FDG uptake or K mono values (p < 0.0001, respectively). FDG uptake was relatively maintained even in the segments with reduced K mono values and reduced BMIPP uptake. HCM shows a variety of metabolic patterns; however, the results of our study suggest that reduction of BMIPP uptake appears to be the most sensitive indicator of metabolic abnormalities followed by reduction of oxidative metabolism in patients with HCM.