Document Detail


Exercise beta-methyl iodophenyl acid (BMIPP) and resting thalium delayed single photon emission computed tomography (SPECT) in the assessment of ischemia and viability.
MedLine Citation:
PMID:  8648880     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To clarify the significance of exercise BMIPP (beta-methyl iodophenyl pentadecanoic acid) and resting T1 delayed single photon emission computed tomography (SPECT) in the assessment of ischemia and viability, we studied maximal exercise-loading BMIPP SPECT following rest-injected T1 3 h SPECT in 11 control subjects, 20 patients with effort angina and 38 patients with old myocardial infarction. The left ventricular wall on ECT was divided into 9 segments. BMIPP and T1 uptake were scored as 0 = normal, 1 = reduced, 2 = severely reduced, or 3 = absent. Discordance was defined as when segments with a reduced BMIPP uptake had a better resting T1 uptake. Significant coronary artery stenosis was defined as stenosis of 75% or greater on coronary arteriogram. Left ventricular wall motion was assessed as either normokinesis, hypokinesis, severe hypokinesis, akinesis or dyskinesis on left ventriculogram. When discordance was considered to be a marker of ischemia, the sensitivity and specificity in effort angina and control subjects were 95.2% and 84.6% for patients and 83.9% and 94.4% for diseased vessels, respectively. There were no differences between the sensitivity and specificity in left anterior descending artery (LAD), left circumflex artery (LCx) and right coronary artery (RCA) lesions (83.3%, 95.5% in LAD, 83.3%, 95.5% in LCx, 85.7%, 92.6% in RCA, respectively). All of the patients with old myocardial infarction had reduced exercise BMIPP uptake in infarcted regions. In old myocardial infarction, 35 patients had segments with discordant uptake. Discordance was observed in 75 (91.5%) of 82 segments with hypokinesis, and in 24 (92.3%) of 26 segments with severe hypokinesis. Even among the 36 segments with akinesis or dyskinesis, 25 (69.0%) had discordant uptake. When discordance in the infarcted region was considered to be a marker of viability, regions with severe asynergy showed a high possibility of viability. Thus, discordant uptake on exercise BMIPP and resting T1 delayed SPECT may be a useful marker of ischemia in effort angina and of viability in old myocardial infarction.
Authors:
T Mori; M Hayakawa; K Hattori; K Awano; J Masuda; T Inatome; H Fukuzaki
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  60     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-07-19     Completed Date:  1996-07-19     Revised Date:  2006-05-06    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  17-26     Citation Subset:  IM    
Affiliation:
Miki City Hospital, Department of Cardiology, Hyogo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / diagnosis
Coronary Angiography
Exercise Test
Fatty Acids / diagnostic use*
Female
Humans
Iodine Radioisotopes / diagnostic use*
Iodobenzenes / diagnostic use*
Male
Middle Aged
Myocardial Infarction / diagnosis
Myocardial Ischemia / diagnosis*
Rest
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Fatty Acids; 0/Iodine Radioisotopes; 0/Iodobenzenes; 0/Thallium Radioisotopes; 116754-87-1/iodofiltic acid

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