Hirai T, Nohara R, Ogoh S, Chen L G, Kataoka K, Li X H, Fujita M, Matsumori A, Taguchi S, Sasayama S
Department of Cardiovascular Medicine, Graduate School of Medicine, and Graduate School of Human and Environmental Studies, Kyoto University, Kyoto, Japan.
J Nucl Cardiol. 2001 Jul-Aug;8(4):472-81. doi: 10.1067/mnc.2001.114519.
Iodine 123-labeled 15-(p-iodophenyl)-3-(R,S)-methylpentadecanoic acid (BMIPP) is mainly trapped in the myocardium as triglyceride, depending on the adenosine triphosphate level. Ten percent to 20% of it is metabolized through alpha-oxidation after beta-oxidation; however, the precise mechanism of the regulatory pathways of BMIPP is yet to be clarified.
A brief left coronary artery occlusion (10-30 minutes) was performed in 28 male Wistar-Kyoto rats. Dual single photon emission computed tomography images of BMIPP and thallium 201 were obtained 3 days and 24 days after the operation. The activities of 3-hydroxyacyl-coenzyme A dehydrogenase (HAD), citrate synthase (CS), and alpha-glycerol-phosphate dehydrogenase (GPD) were then measured in both ischemic and nonischemic regions. BMIPP and Tl-201 chloride severity scores were also evaluated conventionally. CS and HAD levels were significantly lower in the ischemic region than in the nonischemic region in the chronic group (CS, 102.9 +/- 28.1 vs 138.7 +/- 33.7 micromol/g/min, respectively, P =.0051; HAD, 54.7 +/- 20.1 vs 78.6 +/- 18.7 micromol/g/min, respectively, P =.0031). There was no difference in GPD between the ischemic and nonischemic regions. The BMIPP severity score had closer inverse relations with HAD (acute, r = -0.82; chronic, r = -0.80) and CS (acute, r = -0.87; chronic, r = -0.81), but not with GPD, than did Tl-201 chloride severity score.
BMIPP imaging correlates well with the activities of HAD and CS, suggesting that a decrease in BMIPP uptake reflects deterioration of both fatty acid metabolism and citrate cycle and shows information other than regional myocardial perfusion.
123碘标记的15-(对碘苯基)-3-(R,S)-甲基十五烷酸(BMIPP)主要以甘油三酯的形式滞留在心肌中,这取决于三磷酸腺苷水平。其中10%至20%在β氧化后通过α氧化代谢;然而,BMIPP调节途径的确切机制尚待阐明。
对28只雄性Wistar-Kyoto大鼠进行短暂的左冠状动脉闭塞(10 - 30分钟)。在手术后3天和24天获得BMIPP和铊201的双单光子发射计算机断层扫描图像。然后测量缺血和非缺血区域的3-羟酰基辅酶A脱氢酶(HAD)、柠檬酸合酶(CS)和α-甘油磷酸脱氢酶(GPD)的活性。还常规评估了BMIPP和氯化铊201的严重程度评分。在慢性组中,缺血区域的CS和HAD水平显著低于非缺血区域(CS分别为102.9±28.1对138.7±33.7微摩尔/克/分钟,P = 0.0051;HAD分别为54.7±20.1对78.6±18.7微摩尔/克/分钟,P = 0.0031)。缺血和非缺血区域的GPD没有差异。与氯化铊201严重程度评分相比,BMIPP严重程度评分与HAD(急性,r = -0.82;慢性,r = -0.80)和CS(急性,r = -0.87;慢性,r = -0.81)的负相关关系更密切,而与GPD无关。
BMIPP成像与HAD和CS的活性密切相关,表明BMIPP摄取减少反映了脂肪酸代谢和柠檬酸循环的恶化,并显示了除区域心肌灌注之外的信息。