0
Clinical Investigations: CARDIOLOGY |

Prediction of Functional Recovery After Revascularization in Coronary Artery Disease Using 18F-FDG and 123I-BMIPP SPECT*

Hideki Sato, MD; Tsutomu Iwasaki, MD; Takuji Toyama, MD; Yoshiaki Kaneko, MD; Tomio Inoue, MD; Keigo Endo, MD; Ryozo Nagai, MD
Author and Funding Information

*From the Second Department of Internal Medicine (Drs. Sato, Iwasaki, Toyama, Kaneko, and Nagai), and the Department of Nuclear Medicine (Drs. Inoue and Endo), Gunma University School of Medicine, Maebashi, Gunma, Japan.

Correspondence to: Hideki Sato, MD, Second Department of Internal Medicine, Gunma University School of Medicine, 3–39-15 Showa-Machi, Maebashi, Gunma 371-0034, Japan; e-mail: h-sato@mail.gumma.med.or.jp



Chest. 2000;117(1):65-72. doi:10.1378/chest.117.1.65
Text Size: A A A
Published online

Study objectives: Clinical studies comparing fatty acid and glucose metabolism in relation to functional recovery of ischemic myocardium after coronary revascularization are scarce. This study evaluated the recovery of regional and global left ventricular function after coronary revascularization in relation to uptake patterns ofβ -methyl-iodophenyl-pentadecanoic acid (BMIPP) and fluorodeoxyglucose (FDG) in patients with ischemic myocardial dysfunction.

Methods: Patients with ischemic regional wall motion abnormality underwent baseline viability imaging with 18F-FDG, 123I-BMIPP, and 99mTc- methoxyisobutylisonitrile, and the regions with evidence for maintained tissue viability were revascularized. Mismatch of uptake score between two different single-photon emission CT (SPECT) images in the same myocardial region was graded as low or high mismatch. Regional and global left ventricular functional changes after revascularization were analyzed in relation to mismatch severity and difference of total uptake score in each SPECT image pair. A total of 33 vessels in 30 patients related to the asynergic regions were revascularized, and a total of 100 myocardial segments perfused by the revascularized vessels were analyzed.

Results: Segments showing high metabolic mismatch (FDG/BMIPP) had lowest regional wall motion score at baseline, representing the most severely impaired ischemic myocardium, and had highest improvement in regional wall motion score after revascularization. Difference of total uptake score between FDG and BMIPP showed a significant positive correlation with difference of ejection fraction between pre- and postrevascularization (r = 0.774, p < 0.0001).

Conclusions: Combined metabolic SPECT imaging with FDG and BMIPP has the potential to identify severely impaired ischemic myocardium leading to more efficient therapeutic management of patients with coronary artery disease.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543