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Myocardial Emission Computed Tomography with Iodine-123-Labeled Beta-Methyl-Branched Fatty Acid in Patients with Hypertrophic Cardiomyopathy

Third Department of Internal Medicine and Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Japan

Correspondence: For reprints contact: Chinori Kurata, MD, The Third Department of Internal Medicine, Hamamatsu University School of Medicine, 3600 Handa-cho, Hamamatsu, 431-31 Japan.

ABSTRACT

We studied whether emission computed tomography (ECT) with ¹²³I-labeled 15-(p-iodophenyl)-3R,S-methylpentadecanoic acid (BMIPP) shows myocardial distribution different from ²⁰¹TI in hypertrophic cardiomyopathy. In 10 patients with asymmetric septal hypertrophy (ASH), 5 with diffuse hypertrophy and 2 with apical hypertrophy, ECT was acquired 30 min (early) and 4 hr (late) after injection of ¹²³I-BMIPP at rest and was compared with ECT with ²⁰¹TI. In 10 patients with ASH, the relative regional uptake (RRU) of the septum was lower in the early ¹²³I-BMIPP study than in the ²⁰¹TI study, although that of the posterior wall was similar. In the early and late ¹²³I-BMIPP studies, the RRU of the septum was lower in 10 patients with ASH than in 7 without ASH, although that of the posterior wall was similar. In the ²⁰¹TI study, however, the RRU of both the septum and posterior wall was similar in those with and without ASH. Moreover, in 16 patients, the apparent left ventricular size was larger in the early ¹²³I-BMIPP study than in the ²⁰¹TI study, which suggested reduced ¹²³I-BMIPP uptake in the subendocardium. In patients with hypertrophic cardiomyopathy, thus, ¹²³I-BMIPP imaging may reveal impaired regional fatty acid utilization, which is independent of regional perfusion.

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