Single photon emission tomography imaging of myocardial oxidative metabolism with 15-(p-[123I]iodophenyl) pentadecanoic acid in patients with coronary artery disease and aorto-coronary bypass graft surgery |
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Authors: | Joachim Kropp James Likungu Paul G. Kirchhoff Furn F. Knapp Jr. Karl Reichmann Sven N. Reske Hans-Jürgen Biersack |
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Affiliation: | (1) Department of Nuclear Medicine, University of Bonn, Sigmund-Freud-Strasse 25, W-5300 Bonn 1, Germany;(2) Department of Cardiovascular Surgery, University of Bonn, Sigmund-Freud-Strasse 25, W-5300 Bonn 1, ermany;(3) Nuclear Medicine Group, Oak Ridge National Laboratory (ORNL), Oak Ridge, Tennessee, USA;(4) Department of Nuclear Medicine, University of Aachen, W-5100 Aachen, Germany |
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Abstract: | A total of 29 patients with coronary artery disease (CAD) were investigated with 15-(p-[123I] iodophenyl)pentadecanoic acid (123I-IPPA) and sequential single photon emission tomography (SPET). Of these, 19 were studied after aorto-coronary bypass graft surgery. Some 13 patients without evidence of CAD served as a control group. Two SPET studies (early and late) were carried out within 45 min after intravenous administration of 200 MBq 123I-IPPA at peak sub-maximal exercise. Semi-quantification of uptake (related to perfusion) and turnover (linked to metabolism) was obtained by segmental comparison of oblique slices. Taking coronary arteriography as the gold standard, 123I-IPPA scintigraphy had the following figures of merit for sensitivity and specificity in the diagnosis of CAD: for the left anterior descending artery territory 93% and 95%, for the left circumflex artery region 96% and 92%, and for the right coronary artery territory 77% and 92%, respectively. In all, 90% of the reperfused myocardial segments showed an improvement of uptake. Of these, 61% exhibited increased turnover after revascularization and 39% had pathologic turnover and thus a dissociation of improvement of perfusion and oxidative metabolism after surgery.Offprint requests to: J. Kropp |
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Keywords: | Aorto-coronary bypass graft surgery Myocardial ischaemia Radioiodinated fatty acids Cardiac metabolism Fatty acid scintigraphy |
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