Document Detail


Discrepancy between myocardial perfusion and fatty acid metabolism following acute myocardial infarction for evaluating the dysfunctional viable myocardium.
MedLine Citation:
PMID:  22572419     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Following acute myocardial infarction (AMI) the area of myocardial perfusion and metabolism mismatch is designated as dysfunctional viable myocardium. (123)I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) is clinically very useful for evaluating myocardial fatty acid metabolism, and (99)mTc-Tetrofosmin (TF) is a widely used tracer for myocardial perfusion. This study was designed to evaluate the degree of discrepancy between BMIPP and TF at the subacute state of AMI.
METHODS: Fifty-two patients (aged 59 ± 10 years; mean 46 years) with AMI were enrolled, and all of them underwent percutaneous coronary intervention (PCI). Patients were classified according to ST-T change and PCI timing. (123)I-beta-methyl iodophenyl pentadecanoic acid and TF cardiac scintigraphy were performed on 7 ± 3.5 days of admission using a dual headed gamma camera. Perfusion and fatty acid metabolism defect were scored on a 17 segments model.
RESULTS: The mean BMIPP defect score on early and delayed images were 16.67 ± 10.19 and 16.25 ± 10.40, respectively. The mean TF defect score was 10 ± 7.69. Defect score of BMIPP was significantly higher than that of the TF (P < 0.0001; 95% CI 4.32-7.02), and there was a strong correlation between perfusion and metabolism defect score (r = 0.89, P < 0.00001). Forty-seven (90%) patients showed mismatched defect (BMIPP > TF), and 5 (10%) patients showed matched defect (BMIPP = TF). Mismatched defect score (MMDS) was significantly higher in patients with ST-segment elevation myocardial infarction (STEMI) than that of non-ST-segment elevation myocardial infarction (NSTEMI) (P < 0.041; 95% CI 0.11-5.19).
CONCLUSION: At the subacute state of AMI, most of the patients showed perfusion-metabolism mismatch, which represents the dysfunctional viable myocardium, and patients with STEMI showed higher mismatch.
Authors:
Shankar K Biswas; Masayoshi Sarai; Hiroshi Toyama; Hitoshi Hishida; Yukio Ozaki
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Publication Detail:
Type:  Journal Article     Date:  2012-03-26
Journal Detail:
Title:  Indian heart journal     Volume:  64     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2012 Jan-Feb
Date Detail:
Created Date:  2012-05-10     Completed Date:  2013-07-02     Revised Date:  2014-03-28    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  India    
Other Details:
Languages:  eng     Pagination:  16-22     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Circulation*
Cross-Sectional Studies
Fatty Acids / diagnostic use,  metabolism*
Female
Humans
Iodobenzenes / diagnostic use
Male
Middle Aged
Myocardial Infarction / diagnosis*,  metabolism,  pathology,  radionuclide imaging,  therapy
Myocardial Perfusion Imaging* / methods
Myocardial Stunning / diagnosis*,  metabolism,  pathology,  radionuclide imaging,  therapy
Myocardium / metabolism*,  pathology
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Percutaneous Coronary Intervention
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals / diagnostic use
Reproducibility of Results
Time Factors
Tissue Survival
Tomography, Emission-Computed, Single-Photon*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fatty Acids; 0/Iodobenzenes; 0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/Radiopharmaceuticals; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 116754-87-1/iodofiltic acid
Comments/Corrections

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