Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 11/2004

01-11-2004 | Original Article

Incremental predictive value of myocardial scintigraphy with 123I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Authors: Mamoru Nanasato, Haruo Hirayama, Akitada Ando, Satoshi Isobe, Makoto Nonokawa, Yoshimi Kinoshita, Ichiro Nanbu, Mitsuhiro Yokota, Toyoaki Murohara

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 11/2004

Login to get access

Abstract

Purpose

It is unclear whether 123I-labelled β-methyl iodophenyl pentadecanoic acid (123I-BMIPP) myocardial scintigraphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether 123I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac events.

Methods

One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent 201Tl and 123I-BMIPP myocardial scintigraphy. Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34.5 months (12–63 months).

Results

Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of 123I-BMIPP TDSs had a significantly higher rate of MACE (P=0.007). Patients with mismatch between 201Tl and 123I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three). Adding 123I-BMIPP TDS and the mismatch improved the global chi-square value (χ 2=7.2)

Conclusion

Myocardial scintigraphy using 201Tl and 123I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone.
Literature
1.
Zaret BL, Wacker FJT, Terrin ML, Forman SA, Williams DO, Knatterud GL, Braunwald E. Value of radionuclide rest and exercise left ventricular ejection fraction in assessing survival of patients after thrombolytic therapy for acute myocardial infarction: results of thrombolysis in myocardial infarction (TIMI) phase II study. J Am Coll Cardiol 1995;26:73–9CrossRefPubMed
2.
Anderson JL, Platia EV, Hallstrom A, Henthorn RW, Buckingham TA, Carlson MD, Carson PE. Interaction of baseline characteristics with the hazard of encainide, flecainide, and moricizine therapy in patients with myocardial infarction: a possible explanation for increased mortality in the cardiac arrhythmia suppression trial (CAST). Circulation 1994;90:2843–52PubMed
3.
Tamaki N, Kawamoto M, Takahashi N, Yonekura Y, Magata Y, Nohara R, Kambara H, Sasayama S, Hirata K, Ban T. Prognostic value of an increase in fluorine-18 deoxyglucose uptake in patients with myocardial infarction: comparison with stress thallium imaging. J Am Coll Cardiol 1993;15:1621–7
4.
Huitink JM, Visser FC, Bax JJ, van Lingen A, Groenveld AB, Teule GJ, Visser CA. Predictive value of planar 18F-fluorodeoxyglucose imaging for cardiac events in patients after acute myocardial infarction. Am J Cardiol 1998;81:1072–7CrossRefPubMed
5.
Di Carli MF, Davidson M, Little R, Khanna S, Mody FV, Brunken RC, Czernin J, Rokhsar S, Stevenson LW, Laks H. Value of metabolic imaging with positron emission tomography for evaluating prognosis in patients with coronary artery disease and left ventricular dysfunction. Am J Cardiol 1994;73:527–33CrossRefPubMed
6.
Tamaki N, Tadamura E, Kudoh T, Hattori N, Yonekura Y, Nohara R, Sasayama S, Ikebukuro K, Kato H, Konishi J. Prognostic value of iodine-123 labeled BMIPP fatty acid analogue imaging in patients with myocardial infarction. Eur J Nucl Med 1996;23:272–9PubMed
7.
Nakata T, Kobayashi T, Tamaki N, Kobayashi T, Wakabayashi S, Shimoshige K, Oh-hori K, Hamabe K, Hirasawa T, Matsuki T, Shogase M, Furudate M, Shimanoto K. Prognostic value of impaired myocardial fatty acid uptake in patients with acute myocardial infarction. Nucl Med Commun 2000;21:897–906CrossRefPubMed
8.
Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, Pennell DJ, Rumberger JA, Ryan T, Verani MS. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart: a statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. J Nucl Cardiol 2002;9:240–5CrossRefPubMed
9.
Wynne J, Green JH, Mann T, Levin D, Grossman W. Estimation of left ventricular volumes in man from biplane cineangiograms filmed in oblique projections. Am J Cardiol 1978;41:726–32CrossRefPubMed
10.
Gibson RS, Watson DD, Craddock GB, Crampton RS, Kaiser DL, Denny MJ, Beller GA. Prediction of cardiac events after uncomplicated myocardial infarction: a prospective study comparing predischarge exercise thallium-201 scintigraphy and coronary angiography. Circulation 1983;68:321–36PubMed
11.
Brown KA, Weiss RM, Clements JP, Wackers FJ. Usefulness of residual ischemic myocardium within prior infarct zone for identifying patients at high risk late after acute myocardial infarction. Am J Cardiol 1987;60:15–9CrossRefPubMed
12.
Kropp J, Eisenhur M, Ambrose KR, Knapp FF, Franke WG. Pharmacokinetics and metabolism of the methyl-branched fatty acid (BMIPP) in animals and humans. J Nucl Med 1999;40:1484–91PubMed
13.
Hosokawa R, Nohara R, Fujibayashi Y, Okuda K, Ogino M, Hata T, Fujita M, Tamaki N, Konishi J, Sasayama S. Myocardial kinetics of iodine-123-BMIPP in canine myocardium after regional ischemia and reperfusion: implications for clinical SPECT. J Nucl Med 1997;38:1857–63PubMed
14.
Fujiwara S, Takeishi Y, Atsumi H, Yamaki M, Takahashi N, Yamaoka M, Tojo T, Tomoike H. Prediction of functional recovery in acute myocardial infarction: comparison between sestamibi reverse redistribution and sestamibi/BMIPP mismatch. J Nucl Cardiol 1998;5:119–27CrossRefPubMed
15.
Marwick TH, Maclntyre WJ, Lafont A, Nemec JJ, Scalcedo EE. Metabolic response of hibernating and infarcted myocardium to revascularization. A follow-up study of regional perfusion, function and metabolism. Circulation 1992;85:1347–53PubMed
16.
Tanaka R, Nakamuta T. Time course evaluation of myocardial perfusion after reperfusion therapy by 99mTc-tetrofosmin SPECT in patients with acute myocardial infarction. J Nucl Med 2001;42:1351–8PubMed
17.
Mochizuki T, Murase K, Higashino H, Miyagawa M, Sugawara Y, Kikuchi T, Ikezoe J. Ischemic “memory image” in acute myocardial infarction of 123I-BMIPP after reperfusion therapy: a comparison with 99mTc-pyrophosphate and 201Tl dual-isotope SPECT. Ann Nucl Med 2002;16:563–8PubMed
18.
Nohara R, Okuda K, Ogino M, Hosokawa R, Tamaki N, Konishi J, Fujibayashi Y, Yonekura Y, Fujita M, Sasayama S. Evaluation of myocardial viability with iodine-123-BMIPP in a canine model. J Nucl Med 1996;37:1403–7PubMed
19.
Hashimoto A, Nakata T, Tsuchihashi K, Tanaka S, Fujimori K, Iimura O. Post ischemic functional recovery and BMIPP uptake after primary percutaneous transluminal coronary angioplasty in acute myocardial infarction. Am J Cardiol 1996;77:25–30CrossRefPubMed
20.
Hambye AS, Vervaet A, Dobbeleir A, Dendale P, Franken P. Prediction of functional outcome by quantification of sestamibi and BMIPP after acute myocardial infarction. Eur J Nucl Med 2000;27:1494–500CrossRefPubMed
21.
Nakajima K, Shimizu K, Taki J, Uetani Y, Konishi S, Tonami N, Hisada K. Utility of iodine-123-BMIPP in the diagnosis and follow-up of vasospastic angina. J Nucl Med 1995;36:1934–40PubMed
22.
Takeishi Y, Sukekawa H, Saito H, Nisihmura S, Shibu T, Sasaki Y, Tomoike H. Clinical significance of decreased myocardial uptake of 123I-BMIPP in patients with stable angina pectoris. Nucl Med Commun 1995;16:1002–8PubMed
23.
Kudoh E, Tadamura E, Tamaki N, Hattori N, Inubushi M, Kubo S, Magata Y, Nishimura K, Matsuda K, Konishi J. Iodinated free fatty acid and 201Tl uptake in chronically hypoperfused myocardium: histologic correlation study. J Nucl Med 2000;41:293–6PubMed
24.
Franken PR, Geeter FD, Dendale P, Demoor D, Block P, Bossuyt A. Abnormal fatty acid uptake in subacute myocardial infarction after coronary thrombosis: correlation with wall motion and inotropic reserve. J Nucl Med 1994;35:1758–65PubMed
25.
Dendale P, Franken PR, van der Wall EE, de Roos A. Wall thickening at rest and contractile reserve early after myocardial infarction: correlation with myocardial perfusion and metabolism. Coron Artery Dis 1997;8;259–64
26.
Tamaki N, Tadamura E, Kawamoto M, Magata Y, Yonekura Y, Fujibayashi Y, Nohara R, Sasayama S, Konishi J. Decreased uptake of iodinated branched fatty acid analog indicates metabolic alterations in ischemic myocardium. J Nucl Med 1995;36:1974–80PubMed
27.
Tamaki N, Kawamoto M, Tadamura E, Magata Y, Yonekura Y, Nohara R, Sasayama S, Nishimura K, Ban T, Konishi J. Prediction of reversible ischemia after revascularization. Perfusion and metabolic studies with positron emission tomography. Circulation 1995;91:1697–705PubMed
28.
Schöder H, Campisi R, Ohtake T, Hoh CK, Moon DH, Czernin J, Schelbert HR. Blood flow-metabolism imaging with positron emission tomography in patients with diabetes mellitus for the assessment of reversible left ventricular contractile dysfunction. J Am Coll Cardiol 1999;33:1328–37CrossRefPubMed
29.
Taniguchi J, Noma A, Irisawa H. Modification of cardiac action potential by intracellular injection of adenosine triphosphate and related substances in guinea pig single ventricular cells. Circ Res 1983;53:131–9PubMed
30.
Fujibayashi Y, Yonekura Y, Takemura Y, Wada K, Matsumoto K, Tamaki N, Yamamoto K, Konishi J, Yokoyama A. Myocardial accumulation of iodinated beta-methyl-branched fatty acid analogue, iodine-125-15-(p-iodophenyl)-3-(R,S) methylpentadecanoic acid (BMIPP), in relation to ATP concentration. J Nucl Med 1990;31:1818–22PubMed
31.
Grines CL, Cox DA, Stone GW, Garcia E, Mattos LA, Giambartolomei A, Brodie BR, Madonna O, Eijgelshoven M, Lansky AJ, O’Neill WW, Morice MC. Coronary angioplasty with or without stent implantation for acute myocardial infarction. N Engl J Med 1999;341:1949–56CrossRefPubMed
32.
Montalescot G, Barragan P, Wittenberg O, Ecollan P, Elhadad S, Villain P, Boulenc JM, Morice MC, Maillard L, Pansiri M, Choussat R, Pinton P. Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction. N Engl J Med 2001;344:1895–903CrossRefPubMed
33.
Petronio AS, Rovai D, Musumeci G, Baglini R, Nardi C, Limbruno U, Palagi C, Volterrani D, Mariani M. Effects of abciximab on microvascular integrity and left ventricular functional recovery in patients with acute myocardial infarction treated by primary coronary angioplasty. Eur Heart J 2003;24:67–76CrossRefPubMed
34.
Ito H, Taniyama Y, Iwakura K, Nishikawa N, Masuyama T, Kuzuya T, Hori M, Higashino Y, Fujii K, Minamino T. Intravenous nicorandil can preserve microvascular integrity and myocardial viability in patients with reperfused anterior wall myocardial infarction. J Am Coll Cardiol 1999;33:654–60CrossRefPubMed
35.
Fukuzawa S, Ozawa S, Inagaki M, Shimada K, Sugioka J, Tateno K, Ueda M. Nicorandil affords cardiac protection in patients with acute myocardial infarction treated with primary PTCA: assessment with thallium-201/iodine-123 BMIPP dual SPECT. J Nucl Cardiol 2000;7:447–53CrossRefPubMed
36.
Lenderink T, Simoons ML, Van Es G-A, Van de Werf F, Verstraete M, Arnold AE. Benefit of thrombolytic therapy is sustained throughout five years and is related to TIMI perfusion grade 3 but not grade 2 flow at discharge. Circulation 1995;92:1110–6PubMed
37.
Late Study Group. Late assessment of thrombolytic efficacy (LATE) study with alteplase 6–24 hours after onset of acute myocardial infarction. Lancet 1993;342:759–66CrossRefPubMed
38.
Mahmarian JJ, Mahmarian AC, Marks GF, Pratt CM, Verani MS. Role of adenosine thallium-201 tomography for defining long-term risk in patients after acute myocardial infarction. J Am Coll Cardiol 1995;25:1333–40CrossRefPubMed
Metadata
Title
Incremental predictive value of myocardial scintigraphy with 123I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention
Authors
Mamoru Nanasato
Haruo Hirayama
Akitada Ando
Satoshi Isobe
Makoto Nonokawa
Yoshimi Kinoshita
Ichiro Nanbu
Mitsuhiro Yokota
Toyoaki Murohara
Publication date
01-11-2004
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 11/2004
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-004-1556-3

Other articles of this Issue 11/2004

European Journal of Nuclear Medicine and Molecular Imaging 11/2004 Go to the issue

Molecular Imaging

In vitro detection of mdr1 mRNA in murine leukemia cells with 111In-labeled oligonucleotide

Original Article

Treatment of iodine-negative thyroglobulin-positive thyroid cancer: differences in outcome in patients with macrometastases and patients with micrometastases

Letter to the Editor

Radionuclide therapy in oncology: repeated administrations of high dose rate radiopharmaceuticals

Controversies-Against

Is amyloid plaque imaging the key to monitoring brain pathology of Alzheimer’s disease in vivo?

Review Article

Small animal PET: aspects of performance assessment

Original Article

The sentinel node in cervical cancer: scintigraphy and laparoscopic gamma probe-guided biopsy