Ugolini V, Hansen C L, Kulkarni P V, Jansen D E, Akers M S, Corbett J R
Department of Internal Medicine (Cardiovascular Division), University of Texas Health Science Center, Dallas 75235.
Am J Cardiol. 1988 Nov 1;62(13):923-8. doi: 10.1016/0002-9149(88)90894-6.
The radioidinated synthetic fatty acid iodine-123 phenylpentadecanoic acid (IPPA) has proven useful in the identification of regional abnormalities of cardiac metabolism in patients with myocardial ischemia. The present study was performed to test the hypothesis that the myocardial distribution and turnover of fatty acids, assessed noninvasively with IPPA, are altered in patients with cardiomyopathy. Nine normal volunteers and 19 patients with dilated cardiomyopathy of various etiologies underwent cardiac imaging with single-photon emission computed tomography (SPECT) after intravenous injection of IPPA. Apical short-axis and basal short-axis sections were reconstructed and quantitatively analyzed for relative IPPA activity distribution and washout. Patients with congestive cardiomyopathy demonstrated significantly greater heterogeneity of IPPA uptake than normal subjects (maximal percent variation of activity 27 +/- 11 vs 18 +/- 4, p less than 0.01). They also demonstrated a more rapid percent washout rate than control subjects (24 +/- 8 vs 17 +/- 6 for the apical short-axis section, p less than 0.05; 26 +/- 7 vs 18 +/- 5 for the basal short-axis section, p less than 0.01). These abnormalities of fatty acid distribution and turnover were independent of the etiology of the cardiomyopathy. The degree of heterogeneity of IPPA uptake was significantly related to the patients' New York Heart Association functional class (r = 0.64, p less than 0.01). Thus, compared with normal myocardium, the myocardium of patients with congestive cardiomyopathy demonstrates a more heterogeneous distribution of fatty acid uptake, which parallels the clinical severity of the disease. Furthermore, patients with congestive cardiomyopathy demonstrate a more rapid myocardial clearance of the labeled fatty acid, as assessed with SPECT imaging.
放射性碘化合成脂肪酸碘 - 123苯十五烷酸（IPPA）已被证明在识别心肌缺血患者心脏代谢的局部异常方面很有用。本研究旨在检验以下假设：用IPPA进行无创评估时，心肌病患者脂肪酸的心肌分布和周转率会发生改变。9名正常志愿者和19名各种病因的扩张型心肌病患者在静脉注射IPPA后，接受了单光子发射计算机断层扫描（SPECT）心脏成像。重建心尖短轴和基底短轴断层图像，并对IPPA相对活性分布和洗脱进行定量分析。充血性心肌病患者的IPPA摄取异质性明显高于正常受试者（活性最大百分比变化为27±11 vs 18±4，p＜0.01）。他们的心尖短轴断层图像洗脱率百分比也比对照组更快（分别为24±8 vs 17±6，p＜0.05；基底短轴断层图像为26±7 vs 18±5，p＜0.01）。脂肪酸分布和周转率的这些异常与心肌病的病因无关。IPPA摄取的异质性程度与患者的纽约心脏协会功能分级显著相关（r = 0.64，p＜0.01）。因此，与正常心肌相比，充血性心肌病患者的心肌脂肪酸摄取分布更不均匀，这与疾病的临床严重程度平行。此外，通过SPECT成像评估，充血性心肌病患者标记脂肪酸的心肌清除更快。
