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Is I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid imaging useful to evaluate asymptomatic patients with hypertrophic cardiomyopathy?

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Abstract

Purpose: Myocardial imaging with I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid (BMIPP) is useful for predicting the outcome of patients with hypertrophic cardiomyopathy (HCM). But its usefulness in asymptomatic patients is unclear. Materials and methods: Eighteen patients with asymptomatic HCM were examined with BMIPP and exercise stress perfusion imaging and then followed for 4.0 ± 0.8 years. Extent of the defect (total defect score, TDS) and myocardial uptake of BMIPP (%uptake) were calculated to evaluate the BMIPP images. Results: In the first study abnormal findings in the BMIPP and perfusion images were detected of 67 and 22% of the patients, respectively. In the second BMIPP study, the TDS had increased (2.1 ± 2.7 to 4.1 ± 4.9, p < 0.005) and the %uptake had decreased (5.67 ± 0.88% to 4.81 ± 0.91%, p < 0.001), but there were no differences in myocardial perfusion between the first and second study. Exertional dyspnea developed in 17% of the patients, and they were among the one third of the patients with the greatest reduction of %uptake. This group also showed deterioration of left ventricular (LV) %fractional shortening and LV volume in the second study. Conclusions: Abnormal findings on BMIPP images were frequently observed in patients with asymptomatic HCM, and these abnormal findings progressed with time. The greater reduction of %uptake during the follow-up period reflects the deterioration of the LV function.

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References

  1. Maron BJ, Bonow RO, Cannon RO III, Leon MB, Epstein SE. Hypertrophic cardiomyopathy. Interrelations of clinical manifestations, pathophysiology, and therapy. New Eng J Med 1987; 316: 844–852.

    Google Scholar 

  2. Wigle ED, Rakowski H, Kimball BP, Williams WG. Hypertrophic cardiomyopathy. Clinical spectrum and treatment. Circulation 1995; 92: 1680–1692.

    Google Scholar 

  3. Spirito P, Seidman CE, McKenna W, Naron BJ. Clinical course and prognosis of hypertrophiccardiomyopathy in an outpatient population. New Eng J Med 1997; 336: 775–785.

    Google Scholar 

  4. Wynne J, Braunwald E. The cardiomyopathies and myocarditides: toxic, chemical, and physical damage to the heart. In: Braunwald E editor Heart Disease: A Textbook of Cardiovascular Medicine. 4th ed. Philadelphia: WB Saunders, 1992; 1394–1450.

    Google Scholar 

  5. Spirito P, Chiarella F, Carratino L, Berriso MZ, Bellotti P, Vecchio C. Clinical course and prognosis of hypertrophiccardiomyopathy in an outpatient population. New Eng J Med 1989; 320: 749–755.

    Google Scholar 

  6. Yutani C, Imakita M, Ishibashi-Ueda H, et al. Three autopsy cases of progression to left ventricular dilatation in patients with hypertrophic cardiomyopathy. Am Heart J 1985; 109: 545–553.

    Google Scholar 

  7. Spirito P, Maron BJ, Bonow RO, Epstein SE. Occurrence and significance of progressive left ventricular wall thinning and relative cavity dilatation in patients with hypertrophic cardiomyopathy. Am J Cardiol 1987; 60: 123–129.

    Google Scholar 

  8. Maron BJ, Olivotto I, Spirito P, et al. Epidemiology of hypertrophic cardiomyopathy-related death: revisited in a large non-referral-based patient population. Circulation 2000; 102: 858–864.

    Google Scholar 

  9. Bingisser R, Candinas R, Schneider J, Hess OM. Risk factors for systolic dysfunction and ventricular dilatation in hypertrophic cardiomyopathy. Int J Cardiol 1994; 44: 225–233.

    Google Scholar 

  10. Knapp FF, Ambrose KR, Goodman MM. New radioiodinated methyl-branched fatty acids for cardiac study. Eur J Nucl Med 1986; 12: S39–S44.

    Google Scholar 

  11. Tamaki N, Kawamoto M, Yonekura Y, et al. Regional metabolic abnormality in relation to perfusion and wall motion in patients with myocardial infarction: assessment with emission tomography using an iodinated branched fatty acid analog. J Nucl Med 1992; 33: 659–667.

    Google Scholar 

  12. Knapp FF, Franken P, Kropp J. Cardiac SPECT with iodine-123-labeled fatty acids: evaluation of myocardial viability with BMIPP. J Nucl Med 1995; 36: 1022–1030.

    Google Scholar 

  13. Kurata C, Tawarahara K, Taguchi T, et al. Myocardial emission computed tomography with iodine-123-labeled beta-methyl-branched fatty acid in patients with hypertrophic cardiomyopathy. J Nucl Med 1992; 33: 6–13.

    Google Scholar 

  14. Ohtsuki K, Sugihara H, Umamoto I, Nakamura T, Nakagawa T, Nakagawa M. Clinical evaluation of hypertrophic cardiomyopathy by myocardial scintigraphy using 123Ilabeled 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid(123I-BMIPP). Nucl Med Commun 1994; 15: 441–447.

    Google Scholar 

  15. Matuo S, Nakamura Y, Takahashi M, Mitunami K, Kinoshita M. Myocardial metabolic abnormalities in hypertrophic cardiomyopathy assessed by iodine-123-labeled beta-methyl-branched fatty acid myocardial scintigraphy and its relation to exercise-induced ischemia. Jpn Circ J 1998; 62: 167–172.

    Google Scholar 

  16. Nishimura T, Nagata S, Uehara T, et al. Prognosis of hypertrophic cardiomyopathy: assessment by 123I-BMIPP (bmethyl-p-(123I)iodophenyl pentadecanoic acid) myocardial single photon emission computed tomography. Ann Nucl Med 1996; 10: 71–78.

    Google Scholar 

  17. Yoshida M, Nakamura Y, Fukuhara T, et al. Prognostic determinants of hypertrophic cardiomyopathy, the results of the Shiga Cardiomyopathy Study. Jpn Cir J 1995; 59: 745–753.

    Google Scholar 

  18. Shimizu M, Ino H, Okeie K, et al. Cardiac dysfunction and long-term prognosis in patients with nonobstructive hypertrophic cardiomyopathy and abnormal (123)I-15-(p-Iodophenyl)-3(R,S)-methylpentadecanoic acid myocardial scintigraphy. Cardiology 2000; 93: 43–49.

    Google Scholar 

  19. Saolo S, Maron BJ, Bonow RO, Epstein SE. Occurrence and significance of progressive left ventricular wall thinning and relative cavity dilatation in hypertrophic cardiomyopathy. Am J Cardiol 1987; 59: 123–129.

    Google Scholar 

  20. Cecchi F, Olivotto I, Lazzeroni E, et al. Clinical course of hypertrophic cardiomyopathy in a non selected population. The Experience of the Italian Multicenter Cardiomyopathy Study. G Ital Cardiol 1997; 27: 1133–1143.

    Google Scholar 

  21. Berman DS, Kiat HS, Van Train KF, Germano G, Maddahi J, Friedman JD. Myocardial perfusion imaging with technetium-99m-sestamibi: comparative analysis of available imaging protocols. J Nucl Med 1994; 35: 681–688.

    Google Scholar 

  22. Hoe J, Powers J, Iskandrian AE. Exercise-rest same-day SPECT sestamibi imaging to detect coronary artery disease. J Nucl Med 1997; 38: 200–203.

    Google Scholar 

  23. Narita M, Kurihara T. Fatty acid metabolism in patients with idiopathic dilated cardiomyopathy: characteristics and prognostic implications. J Cardiol 1995; 25: 223–231.

    Google Scholar 

  24. Narita M, Kurihara T, Shindoh T, Honda M. Clinical significance of myocardial 123I-BMIPP imaging in patients with myocardial infarction. Kakuigaku 1997; 34: 177–187.

    Google Scholar 

  25. Torizuka K, Yonekura Y, Nishimura T, et al. The phase 1 study of b-methyl-p(123I) iodo-phenyl-pentadecanoic acid (123I-BMIPP). Kakuigaku 1991; 28: 681–690.

    Google Scholar 

  26. Tsuchimoto S, Tamaki N, Kawamoto M, et al. Myocardial uptake ratio of Iodine-123 labeled beta-methyl iodophenylpentadecanoic acid (123I-BMIPP) in relation to the concentration of substrate of energy. Kakuigaku 1995; 32: 579–586.

    Google Scholar 

  27. Sahn DJ, DeMaria A, Kisslo J, Weyman A. Recommendation regarding quantitation in M-mode echocardiography: result of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.

    Google Scholar 

  28. Groven-McKay M, Schwaiger M, Krivokapich J, Kerloff JK, Phelps ME, Scherbert HR. Regional myocardial blood flow and metabolism at rest in mildly symptomatic patients with hypertrophic cardiomyopathy. J Am Coll Cardiol 1989; 13: 317–324.

    Google Scholar 

  29. Hina K, Kusachi S, Iwasaki K, et al. Progression of left ventricular enlargement in patients with hypertrophic cardiomyopathy: incidence and prognostic value. Clin Cardiol 1993; 16: 403–407.

    Google Scholar 

  30. Ishiwata S, Nishiyama S, Nakanishi S, et al. Natural history of 82 patients with hypertrophic cardiomyopathy: follow-up for over ten years. J Cardiol 1991; 21: 61–73.

    Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Sumitomo Hospital, Osaka, Japan

    Michihiro Narita & Tadashi Kurihara

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  1. Michihiro Narita
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  2. Tadashi Kurihara
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Narita, M., Kurihara, T. Is I-123-beta-methyl-p-iodophenyl-methylpentadecanoic acid imaging useful to evaluate asymptomatic patients with hypertrophic cardiomyopathy?. Int J Cardiovasc Imaging 19, 499–510 (2003). https://doi.org/10.1023/B:CAIM.0000004262.48898.5d

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  • DOI: https://doi.org/10.1023/B:CAIM.0000004262.48898.5d

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