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Relationship between blood flow and fatty acid metabolism in subacute myocardial infarction: a study by means of99mTc-Sestamibi and23I-β-methyl-iodo-phenyl pentadecanoic acid

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Abstract

Contradictory data have been published on the relative behaviour of fatty acids and flow tracers during the subacute stage of myocardial infarction. Therefore, the present study was set up (1) to investigate the potential occurrence of mismatches between β-methyl-iodophenyl pentadecanoic acid (BMIPP), a fatty acid analogue, and Sestamibi, and to describe their nature, and (2) to relate these mismatches to clinical characteristics such as whether or not thrombolysis or percutaneous transluminal coronary angioplasty (PTCA) had been performed. Twenty-six patients were studied within 2 weeks after myocardial infarction. Sestamibi and BMIPP single-photon emission tomography (SPET) were performed within 4 days of one another. Activity of both tracers was scored in 16 basal, 16 midventricular and 8 apical segments, using a four-point grading system: 3 = normal (≥65% of maximum activity), 2 = mildly decreased (45%–64%), 1 = moderately decreased (25%–44%), 0 = severely decreased (0%–24%). Coronary arteriography was obtained during the same hospital stay. Four hundred and seventy-seven segments out of 1040 studied were abnormal for at least one tracer: 197 with higher Sestamibi activity (group I), 226 with equal scores for Sestamibi and BMIPP (group II) and 54 with higher BMIPP activity (group III). Seventy-five percent of group I segments and 84% of group III segments were found in infarct-related artery territories. Group I segments were associated with acute thrombolysis and/or PTCA (P < 0.01), and with the absence of prior infarction in the territory of the infarct-related artery (P < 0.001). Group III segments were associated with the absence of thrombolysis or PTCA (P < 0.001), with occlusion of the infarct-related artery (P < 0.001), with previous infarction in the same territory (P < 0.001) and with a- or dyskinesia in this territory (P < 0.001). These data could support the interpretation that areas in which the uptake of BMIPP is more decreased than that of Sestamibi (group I) are due to delayed recovery of fatty acid metabolism after reperfusion, whereas those with higher BMIPP than Sestamibi activity (group III) are accounted for by the enhanced metabolism induced by passive systolic wall stretch.

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Author notes

  1. F. De Geeter

    Present address: Academisch Ziekenhuis VUB, Dienst Nucleaire Geneeskunde, Laarbeeklaan 101, B-1090, Brussels, Belgium

Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital Vrije Universiteit, 101 Laarbeeklaan, B-1090, Brussels, Belgium

    F. De Geeter, F. R. Franken & A. Bossuyt

  2. Oak Ridge National Laboratory, 37831-6022, Oak Ridge, TN, USA

    F. F. Knapp Jr

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  1. F. De Geeter
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  2. F. R. Franken
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  3. F. F. Knapp Jr
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  4. A. Bossuyt
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De Geeter, F., Franken, F.R., Knapp, F.F. et al. Relationship between blood flow and fatty acid metabolism in subacute myocardial infarction: a study by means of99mTc-Sestamibi and23I-β-methyl-iodo-phenyl pentadecanoic acid. Eur J Nucl Med 21, 283–291 (1994). https://doi.org/10.1007/BF00947962

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  • DOI: https://doi.org/10.1007/BF00947962

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