Prognostic value of impaired myocardial fatty acid uptake in patients with acute myocardial infarction.

Abstract

Impaired cardiac fatty acid uptake, assessed by the radiolabelled fatty acid analogue beta-methyl-p-iodophenyl pentadecanoic acid (I-123-BMIPP), is observed in the myocardium following acute ischaemic events, but the long-term prognostic implication has not been established. This study aimed to determine the prognostic value of cardiac BMIPP uptake in patients with acute myocardial infarction. Following the assessment of thallium-201 and I-123-BMIPP uptake, 101 post-infarct patients were prospectively followed up with primary end points of cardiac death, heart failure and non-fatal infarction. During a mean follow-up of 28 months, three cardiac deaths, three non-fatal infarctions, 23 revascularizations and four recurrences of angina pectoris were observed. Multivariate analysis identified reduced uptake of BMIPP and perfusion, no beta-blocking treatment and greater thallium-BMIPP mismatch (i.e. larger BMIPP defect than thallium defect) as significant predictors for overall cardiac events. Prior myocardial infarction, reduced left ventricular ejection fraction and greater thallium-BMIPP mismatch were selected as independent predictors of harder cardiac events. Female patients, those with greater BMIPP defect or greater thallium-BMIPP mismatch showed worse clinical outcomes. The inclusion of BMIPP data improved the prognostic values of conventional significant predictors. In conclusion, impaired myocardial I-123-BMIPP uptake and perfusion-BMIPP mismatch are related to a high probability of fatal and non-fatal cardiac events, suggesting the aetiological relevance and prognostic value of impaired cardiac fatty acid metabolism in viable, but jeopardized, myocardium following acute myocardial infarction.

• Authors: T Nakata, T Kobayashi, N Tamaki, H Kobayashi, T Wakabayashi, S Shimoshige, K Oh-Hori, K Hamabe, K Hirasawa, T Matsuki, T Shogase, M Furudate, K Shimamoto
• Journal: Nuclear medicine communications (Nucl Med Commun) Vol. 21 Issue 10 Pg. 897-906 (Oct 2000) ISSN: 0143-3636 [Print] England
• PMID: 11130330 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Fatty Acids
• Iodine Radioisotopes
• Iodobenzenes
• Radiopharmaceuticals
• Thallium Radioisotopes
• iodofiltic acid

Topics

• Adult
• Aged
• Aged, 80 and over
• Biological Transport, Active
• Death, Sudden, Cardiac
• Fatty Acids (metabolism)
• Female
• Follow-Up Studies
• Heart (diagnostic imaging)
• Humans
• Iodine Radioisotopes
• Iodobenzenes
• Male
• Middle Aged
• Myocardial Infarction (diagnostic imaging, metabolism)
• Myocardium (metabolism)
• Prognosis
• Radionuclide Imaging
• Radiopharmaceuticals
• Recurrence
• Thallium Radioisotopes