Late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) imaging can
help detect myocardial damage. 123I-betamethyl-p-iodophenyl-pentadecanoic acid single-photon emission computed tomography
(BMIPP-SPECT) was developed to evaluate fatty acid metabolism and has been reported
to help detect myocardial damage in cardiac sarcoidosis (CS). We analyzed data from
CMR-LGE and performed BMIPP-SPECT in patients with CS taking prednisolone and investigated
the association of BMIPP-SPECT with LGE as a prognostic factor in CS. Patients with
CS who underwent BMIPP-SPECT and CMR-LGE at the time of diagnosis within 2 months
were classified into those with and without a major adverse cardiac event (MACE).
Total BMIPP-SPECT defect score (BDS) and LGE extent score (LES) were used to estimate
myocardial damage. The relation between BDS and LES was explored using Pearson's correlation
coefficient. Their ability to predict MACEs was analyzed using Kaplan-Meier analysis.
Medical data of 45 patients were analyzed retrospectively (mean follow-up, 4.5 years).
BDS and LES were significantly correlated (p <0.0001). BDS was significantly greater
for the group with MACE than that without MACE (p = 0.0008). LES of patients with
MACE was significantly greater than those without MACE (p = 0.0045). Patients with
BDS ≥16 had a significantly higher MACE rate than those with BDS <16 (p = 0.0029).
The group with LES ≥9 was significantly associated with MACE (p = 0.0098). In conclusion,
BDS reflected myocardial damage similar to that detected by CMR-LGE and was a predictive
marker of MACE in patients with CS. BMIPP-SPECT may help predict the prognosis of
patients with CS who cannot undergo CMR-LGE.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of CardiologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Complementary role of CMR to conventional screening in the diagnosis and prognosis of cardiac sarcoidosis.JACC Cardiovasc Imaging. 2017; 10: 1437-1447
- Central Japan Heart Study Group. Prognostic determinants of long-term survival in Japanese patients with cardiac sarcoidosis treated with prednisone.Am J Cardiol. 2001; 88: 1006-1010
- Complementary value of cardiac magnetic resonance imaging and positron emission tomography/computed tomography in the assessment of cardiac sarcoidosis.Circ Cardiovasc Imaging. 2018; 11e007030
- Detection of myocardial damage in patients with sarcoidosis.Circulation. 2009; 120: 1969-1977
- Cardiac involvement in patients with sarcoidosis: diagnostic and prognostic value of outpatient testing.Chest. 2008; 133: 1426-1435
- CMR imaging predicts death and other adverse events in suspected cardiac sarcoidosis.JACC Cardiovasc Imaging. 2013; 6: 501-511
- Incidence and prognostic significance of myocardial late gadolinium enhancement in patients with sarcoidosis without cardiac manifestation.Chest. 2014; 146: 1064-1072
- Regional myocardial damage and active inflammation in patients with cardiac sarcoidosis detected by non-invasive multi-modal imaging.Ann Nucl Med. 2017; 31: 135-143
- Incremental predictive value of myocardial scintigraphy with 123I-BMIPP in patients with acute myocardial infarction treated with primary percutaneous coronary intervention.Eur J Nucl Med Mol Imaging. 2004; 31: 1512-1521
- Prognostic value of I-123 15-(p-iodophenyl)-3-(R,S) methylpentadecanoic acid myocardial imaging in patients with known or suspected coronary artery disease.J Nucl Cardiol. 2005; 12: 172-178
- Diagnosis and detection of myocardial injury in active cardiac sarcoidosis—significance of myocardial fatty acid metabolism and myocardial perfusion mismatch.Circ J. 2015; 79: 2669-2676
- Guidelines for diagnosis and treatment of myocarditis (JCS 2009): digest version.Circ J. 2011; 75: 734-743
- Japanese Circulation Society Joint Working Group. JCS 2016 guideline on diagnosis and treatment of cardiac sarcoidosis– digest version.Circ J. 2019; 83: 2329-2388
- Prognosis and recurrence in cardiac sarcoidosis: serial assessment of BMIPP SPECT and FDG-PET.J Nucl Cardiol. 2021; 28: 919-929
- Prognostic value of 123I-BMIPP SPECT in patients with nonischemic heart failure with preserved ejection fraction.J Nucl Med. 2018; 59: 259-265
- Metabolism of iodine-123-BMIPP in perfused rat hearts.J Nucl Med. 1995; 36: 1043-1050
- Lack of myocardial iodine-123 15-(p-iodiphenyl)-3-R,S-methylpentadecanoic acid (BMIPP) uptake and CD36 abnormality—CD36 deficiency and hypertrophic cardiomyopathy.Jpn Circ J. 1997; 61: 724-725
- Myocardial accumulation of iodinated beta-methyl-branched fatty acid analog, iodine-125-15-(p-iodophenyl)-3-(R,S)methylpentadecanoic acid (BMIPP), in relation to ATP concentration.J Nucl Med. 1990; 31: 1818-1822
- Metabolism and kinetics of iodine-123-BMIPP in canine myocardium.J Nucl Med. 1996; 37: 757-761
- Myocardial kinetics of iodine-123-BMIPP in canine myocardium after regional ischemia and reperfusion: implications for clinical SPECT.J Nucl Med. 1997; 38: 1857-1863
Article Info
Publication History
Published online: July 30, 2022
Received in revised form:
May 26,
2022
Received:
April 11,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Funding: none.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
