Abstract
1445
Objectives: [I-123]-beta-methyl-iodophenyl pentadecanoic acid (BMIPP) is a common radionuclide tracer for fatty acid metabolism. It is useful to find regional ischemic memory in patients with exercise-induced myocardial ischemia. However, significance in the delayed image is still unclear. We examined the hypothesis that BMIPP fill-in calculated by the pair of early and delayed images could predict cardiac mortality and hospitalization for cardiac event.
Methods: A total of 116 patients with BMIPP scintigraphy performing both early and delayed scan were retrospectively reviewed. We defined more than 10% of myocardium with fill-in as positive fill-in. We generated the survivor function and the cumulative hazard function to assess the above hypothesis. If the patient underwent both BMIPP and myocardial perfusion SPECT, we examined the hypothesis that BMIPP and/or perfusion SPECT findings could predict cardiac mortality and hospitalization for cardiac event. All of the SPECT met the medical and technical standard under the health insurance at the time of the scan implementation.
Results: 52 patients (45%) were BMIPP positive fill-in (B+); 64 patients (55%), negative (B-). We assessed their medical record for 11 years at most. 4 patients in B+ had cardiac mortality; in contrast, no patients in B- did (p < 0.05 in Log-rank test). Hospitalization for cardiac event was not different in B+ and B-. 86 patients underwent BMIPP and myocardial perfusion SPECT, which involved 24 patients in ischemic finding (I+) and 62 patients in non-ischemic finding (I-). All of the 4 patients with cardiac mortality found I-. The hazard ratios for cardiac mortality and hospitalization for cardiac event were 0.50 in B-I-, 1.35 in B-I+, 1.64 in B+I-, and 2.38 in B+I+.
Conclusions: Delayed image of myocardial fatty acid metabolism SPECT can predict cardiac mortality. Adding myocardial perfusion SPECT is possible to predict cardiac event.