Simultaneous dual myocardial imaging with iodine-123-β -methyl iodophenyl-pentadecanoic acid (BMIPP) and thallium-201 in patients with coronary heart disease

Abstract

To assess the clinical value of simultaneous dual myocardial imaging with iodine-123- β-methyl-iodophenyl-pentadecanoic acid (123I-BMIPP) and thallium-201 (201T1), myocardial imaging was performed at rest and during exercise in seven patients with coronary heart disease. When 123I-BMIPP and 201T1 images were compared, the initial exercise and resting images agreed 87% and 64%, respectively. In the initial resting images, the regional uptake of 123I-BMIPP was frequently less than that of 201T1. The incidence of exercise-induced reversible defects by 201T1 in the T1>BMIPP regions was significantly higher than that in the T1=BMIPP regions (57% vs 4%, p<0.01) and the incidence of coronary narrowing of more than 90% in the Tl>BMIPP regions was also significantly higher than that in the Tl = BMIPP regions (91% vs 38%, p<0.01). In addition, this disparity (T1>BMIPP) was found more frequently in regions with abnormal wall motion than in regions with normal wall motion (hypokinetic regions; 68%, severe hypokinetic or akinetic regions; 50%, vs normokinetic regions; 4%, p<0.01). In contrast, the uptake of 123I-BMIPP correlated closely with that of 201T1 in normal myocardium and the uptake of both 123I-BMIPP and 201T1 was severely reduced in myocardium with severe ischemia during exercise and prior infarction. These results indicate that dual myocardial imaging with 123I-BMIPP and 201T1 may provide a unique means of identifying patients with metabolically disturbed mvocardium, such as hibernating and stunned myocardium. © 1994, The Japanese Circulation Society. All rights reserved.