The relationship between discrepant areas on 201TlCl/123I-BMIPP myocardial scintigraphy, local wall motion, and glucose metabolism in patients with myocardial infarction

In order to clarify the significance of the discrepancy between myocardial blood flow and fatty acid metabolism on 201TlCl/123I-BMIPP SPECT after acute myocardial infarction, we examined 52 patients (278 segments) with their first acute myocardial infarction using two-dimensional echocardiography and FDG-PET. Patients with Tl/BMIPP discrepancy in the acute stage showed higher FDG accumulation than those without Tl/BMIPP discrepancy. In the chronic stage, however, there was no significant difference between both groups. Patients with Tl/BMIPP discrepancy in the chronic stage had lower wall motion scores than those without Tl/BMIPP discrepancy. Significant improvement of the wall motion score was recognized in patients who showed Tl/BMIPP discrepancy in the acute stage. Patients were classified into stenosis and non-stenosis groups by the presence of significant stenosis on coronary angiography in the chronic stage. In the stenosis group, the Tl/BMIPP discrepancy did not show much change from the acute to chronic stage, but there was a significant decrease in the non-stenosis group. It was concluded that 201TlCl/123I-BMIPP myocardial SPECT is useful for predicting future improvement of wall motion and determining the residual ischemia in the chronic stage based on the presence or absence of this discrepancy.