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Iodine-123-BMIPP Myocardial Washout and Cardiac Work During Exercise in Normal and Ischemic Hearts

Department of Radiology, Mie University School of Medicine and Matsusaka Chuo Hospital, Mie, Japan

Correspondence: For correspondence or reprints contact: Kan Takeda, MD, Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514, Japan.

ABSTRACT

Iodine-123-BMIPP washout at rest and after exercise was investigated in relation to cardiac work in normal and ischemic myocardium. Methods: Sixteen healthy volunteers and 10 patients with ischemic heart disease were examined. After injection of 111 MBq of ¹²³I-BMIPP, successive SPECT imaging was performed to evaluate washout ratio (WR) at rest and after mild and maximal exercise. Results: In the healthy volunteers, the mean WR was 3.3 ± 3.5% after 1 hr of rest and increased during both mild and maximal exercise. The WR showed a better correlation with net pressure rate product (PRP) than with the peak PRP. After maximal exercise, the WR showed a distinct correlation with the net PRP in the range from 200–300 x 10³ mmHg/min and then showed a plateau greater than 10%. In five ischemic heart disease patients with the net PRP 300 x 10³ mmHg/min, the exercise WR values were significantly elevated in normal segments relative to ischemic segments .Conclusion: BMIPP washout increased with the increase in cardiac work during exercise in normal myocardium but not in ischemic myocardium. A certain amount of exercise is necessary to evaluate fatty acid metabolism in normal and ischemic myocardium.

Key Words: ¹²³I-BMIPP • washout ratio • pressure rate product • ischemic heart disease • SPECT

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