Iodine-123-BMIPP imaging in unstable angina: a guide for interventional strategy.

Abstract

The aim of this study was to clarify the clinical implications of decreased myocardial uptakes of 123I-labeled beta-methyl-p-iodophenyl-pentadecanoic acid (123I-BMIPP) in patients with unstable angina. Fatty acid metabolic imaging with 123I-BMIPP was performed in 20 patients with unstable angina during the pain-free state. Regional uptakes of 123I-BMIPP were scored semiquantitatively, and clinical characteristics and angiographic findings were compared between the patients with the normal and abnormal 123I-BMIPP images. There were 9 patients with normal and 11 patients with abnormal 123I-BMIPP images. Severe coronary stenosis exceeding 90% (91% compared with 44%, p < 0.05) and 99% (82% compared with 0%, p < 0.01) and collateral opacification (36% compared with 0%, p < 0.05) were more frequently observed in patients with abnormal 123I-BMIPP images than in those with normal images. Percutaneous transluminal coronary angioplasty or coronary artery bypass grafting was performed in 22% of patients with normal 123I-BMIPP images and in 82% of patients with abnormal 123I-BMIPP images (p < 0.01). Fatty acid metabolic imaging with 123I-BMIPP can determine the functional severity of coronary artery disease and is helpful for a clinical judgment in interventional treatment.