A compartment model analysis for investigation of myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy
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This is a non-final version of an article published in final form in Okizaki, Atsutaka ; Shuke, Noriyuki ; Sato, Junichi ; Sasaki, Tomoaki ; Hasebe, Naoyuki ; Kikuchi, Kenjiro ; Aburano, Tamio, A compartment model analysis for investigation of myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy, Nuclear Medicine Communications 28(9), SEP 2007, pp. 726-735authorObjective: The purpose of this study was to investigate the myocardial fatty acid metabolism in patients with hypertrophic cardiomyopathy (HCM) from dynamic SPECT through a compartment model analysis. Methods: Twenty-four normal controls, 7 patients with left ventricular hypertrophy (LVH) due to essential hypertension (eHT), and 30 patients with HCM were studied. I-123 BMIPP and Tc-99m tetrofosmin SPECT were performed. All the myocardium was divided into 13 segments, and totally 390 segments of HCM were categorized into early, moderately and severely advanced HCM segments, based on these SPECT imaging. By using the myocardial and blood pool time-activity curves, BMIPP pharmacokinetics was analyzed through a 2-compartment model. We defined k1 and k2 as influx and outflux rate constants between blood and myocardial reversible component, k3 as specific uptake rate constant between myocardial reversible and irreversible compartments. Results: The averages of k3 in HCM were higher than in normal. In contrast, the averages of k1/k2 in HCM were lower than in normal, and gradually decreased with progression of HCM. There are no significant differences in these indexes between normal controls and patients with LVH due to eHT. Conclusion: k3 might be a sensitive predictor for early detection of HCM, and k1/k2 could be a useful index to evaluate its progression. A mathematical compartment model analysis with BMIPP SPECT study might be useful not only for identification of HCM in very early stage, but also for evaluation of the progression of HCM.
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