Keisuke Kiso, Presenter: Nothing to Disclose

Yoshio Ishida MD, Abstract Co-Author: Nothing to Disclose

Kazuki Fukuchi MD, Abstract Co-Author: Nothing to Disclose

I-123 BMIPP (BMIPP) SPECT is used for assessing the severity of coronary artery disease (CAD) in terms of ischemia-induced metabolic abnormality. Meanwhile, N-13 Ammonia (NH3) PET is useful for detecting the myocardial ischemia by quantifying coronary flow reserve (CFR). The aim of this study was to elucidate the relationship between myocardial fatty acid metabolism (MFAM) and CFR with the consideration of % stenosis of coronary artery (%CAS).

Twenty-five patients with chronic CAD were enrolled for this study(OMI : Angina=5:20, male : female=20:5, mean age=66.9±9.0). We estimated MFAM by BMIPP SPECT, CFR by NH3 PET, and %CAS by CAG in those patients. Because of the unreliable results in calculating the CFR, basal myocardium was excluded from the estimation. The rest of myocardium was divided into 8 segments, and total 193 segments could be evaluated. Those segments were divided into three groups; Group A with normal BMIPP uptake which was fed by normal coronary artery, Group B with normal BMIPP uptake which was fed by significant stenosed coronary artery (75% stenosis or more), and Group C with reduced BMIPP uptake which was fed by significant stenosed coronary artery. There was no segment fed by normal coronary artery with reduced BMIPP uptake.

We compared the CFR between the group with normal BMIPP uptake (Group A+B) and that with reduced BMIPP uptake (Group C). The CFR of Group C was significant lower than the other group (Group A+B = 2.08±0.89, Group C = 1.71±0.66, P<0.05). Moreover, Group A had significant higher CFR than the other two groups ( Group A = 2.45±1.0, Group B = 1.83±0.71, Group C = 1.71 ± 0.66, P<0.0001; Group A vs. B, P<0.005; Group A vs. C). On the other hand, there was no significant difference in CFR between Group B and C. However, comparing %CAS between Group B and C, Group C was fed by more severe stenosed coronary artery than Group B (Group B = 84.8±11.8%, Group C = 92.4±10.6 %, P<0.05).

These relults suggest that the impairment of MFAM may relate to the reduced CFR, and the combined study of BMIPP SPECT and NH3 PET may be useful for speculation on %CAS in the chronic CAD patients.

Kiso, K, Ishida, Y, Fukuchi, K, The Combined Study of I-123 BMIPP SPECT and N-13 Ammonia PET May Be Useful for Predicting the Degree of Coronary Artery Stenosis in Patients with Coronary Artery Disease.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4408411.html