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Iodinated Free Fatty Acid and ²⁰¹Tl Uptake in Chronically Hypoperfused Myocardium: Histologic Correlation Study

Department of Nuclear Medicine and Diagnostic Imaging and Department of Cardiovascular Surgery, School of Medicine, Kyoto University, Kyoto
Department of Nuclear Medicine, School of Medicine, Hokkaido University, Sapporo, Japan

Correspondence: For correspondence or reprints contact: Takashi Kudoh, MD, Department of Radiology, Kinki University, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan.

ABSTRACT

¹²³I-15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) is a tracer for the evaluation of ischemic heart disease. The purpose of this study was to assess the relationship between ¹²³I-BMIPP uptake and myocardial fibrosis. Methods: Fifteen patients who underwent cardiac surgery were examined by imaging with ²⁰¹Tl and ¹²³I-BMIPP, and histologic specimens were taken during surgery. The relative uptake of ²⁰¹Tl (%TI) and that of ¹²³I-BMIPP (%BMIPP) were calculated. The percentage of fibrosis (%fibrosis) was analyzed with the specimen. Results: %TI correlated strongly with %fibrosis (r = -0.94; P < 0.001). %BMIPP also correlated significantly with %fibrosis (r = -0.88; P < 0.001), but the change in %BMIPP looked biphasic. In the category of only mild fibrosis, %BMIPP showed a steep decrease. ¹²³I-BMIPP–²⁰¹Tl mismatch was found only for fibrosis <20%. Conclusion: ¹²³I-BMIPP gave specific information about metabolic changes that occurred in ischemic myocardium without severe fibrotic changes.

Key Words: ¹²³I-BMIPP • ²⁰¹Tl • myocardial fibrosis • metabolism

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