Japanese
Title心筋梗塞における123I-BMIPP心筋イメージング : その臨床的有用性
Subtitle《原著》
Authors成田充啓*, 栗原正*, 新藤高士*, 本田稔**
Authors(kana)
Organization*住友病院循環器科, **住友病院アイソトープ検査部
Journal核医学
Volume34
Number3
Page177-187
Year/Month1997/3
Article原著
Publisher日本核医学会
Abstract「要旨」心筋梗塞(MI)55例を対象に123I-BMIPPイメージング(PPI)を行い, 99mTc-MIBIによる運動負荷(Ex), 安静時(R)心筋灌流イメージング(MPI), 左室造影をもとにセンターライン法で求めた左室壁運動(WM)と対比した. 30例(55%)でPPIの欠損はR-MPIの欠損より大であった. このミスマッチ区域はExで欠損の拡大する例では92%(24/26)に存在, jeopardized myocardiumに一致していた. 急性期に梗塞責任血管の再疎通をきたした亜急性期のMIではMPIは固定性欠損を示したが, 55%(6/11)でMI周辺部にミスマッチ区域が存在した. ミスマッチ区域でのWMはR-MPI, PPIが正常であった区域より有意の低下(-2.14±0.50vs. -0.41±0.77, p<0.001)を示しstunningの存在を示唆した. これらの結果は高度の虚血が生じた後には心筋灌流の回復後も長期にわたり心筋脂肪酸代謝障害が存在すること, Exで虚血が誘発される症例では臨床症状の有無に関わらず繰り返し心筋虚血が生じている可能性を示唆し, PPIはMIにおいて心筋虚血の履歴を知る上で有用と考えられた.
Practice臨床医学：一般
Keywords123I-BMIPP myocardial imaging, Myocardial infarction, Myocardial perfusion, Left ventricular wall motion, Stunned myocardium.
English
TitleClinical Significance of Myocardial 123I-BMIPP Imaging in Patients with Myocardial Infarction
Subtitle- Original Articles -
AuthorsMichihiro NARITA*, Tadashi KURIHARA*, Takashi SHINDOH*, Minoru HONDA**
Authors(kana)
Organization*Department of Cardiology, Sumitomo Hospital, **Department of Nuclear Medicine, Sumitomo Hospital
JournalThe Japanese Journal of nuclear medicine
Volume34
Number3
Page177-187
Year/Month1997/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractIn order to clarify the characteristics of fatty acid metabolism in patients with myocardial infarction (MI), we performed myocardial imaging with 123I-β-methyl-p-iodophenylpentadecanoic acid (BMIPP) and we compared these findings with exercise stress (Ex) and resting myocardial perfusion imaging with 99mTc-methoxyisobutylisonitrile (MIBI) and left ventricular wall motion index (WMI) which were obtained by left ventriculography. We studied 55 patients with MI, 14 patients with recent MI (RMI) and 41 patients with old MI (OMI), and myocardial images were divided into 17 segments and myocardial uptake of the radionuclide was graded from 0 (normal) to 3 (maximal abnormality). In 28 patients we compared segmental defect score (SDS) with WMI which were obtained by centerline method at the corresponded segments. As a whole, the mean total defect scores (TDSs) of BMIPP and Ex were similar and they were greater than the mean TDS of resting perfusion. In 30 patient (55%) TDS of BMIPP was greater than that of TDS of resting perfusion. In 24 patients perfusion abnormality developed by Ex and the location of BMIPP abnormality coincided with the abnormality of Ex. But in the other 6 patients Ex did not induce any abnormality and they were all RMI and infarcted coronary artery was patent. However in the group with TDS of BMIPP identical to TDS of resting perfusion (25 patients), 92% did not show myocardial perfusion abnormality after Ex. In the comparison of SDS and WMI, myocardial segments were divided into 3 groups; both SDSs of BMIPP and resting perfusion were normal or borderline abnormality (Group 1, 82 segments), SDS of resting perfusion was normal or borderline and SDS of BMIPP was definitely abnormal (Group 2, 10 segments) and both SDSs of BMIPP and resting perfusion were definitely abnormal (Group 3, 48 segments). In Group 1, WMS (-0.41+-0.77) was significantly (p<0.001) greater than those of Group 2 (-2.14+-0.50) and Group 3 (-2.32+-0.67). But there was no difference between Group 2 and 3. These findings suggested that in the segments with mismatch between BMIPP and resting perfusion reflects stunned myocardium. These results suggested that in half of the patients with MI, abnormal fatty acid metabolism may appear in viable myocardium such as jeopardized myocardium and myocardium which recently recovered from severe ischemia like acute MI and BMIPP imaging was useful to know the history of myocardial ischemia.
PracticeClinical medicine
Keywords123I-BMIPP myocardial imaging, Myocardial infarction, Myocardial perfusion, Left ventricular wall motion, Stunned myocardium.

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