Prediction of Functional Outcome in Stunned Myocardium after Myocardial Infarction using BMIPP and Tetrofosmin Imaging

The predictive value of combined ¹²³iodine-labelled 15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid imaging (¹²³I-BMIPP) and early technetium-99m (^99mTc)-tetrofosmin imaging was compared with combined ¹²³I-BMIPP and delayed ^99mTc-tetrofosmin or ¹²³I-BMIPP and thallium-201 (²⁰¹Tl) imaging for functional outcome of stunned myocardium after acute myocardial infarction (AMI) in 37 patients with AMI. All patients underwent successful percutaneous coronary intervention with/without stenting within 24 h of symptoms. Resting ²⁰¹Tl, ^99mTc-tetrofosmin and ¹²³I-BMIPP imaging were performed within 10 days of hospital admission; ^99mTc-tetrofosmin imaging was also performed 6 months later. Segments were mismatched when the ¹²³I-BMIPP score was greater than the ^99mTc-tetrofosmin or ²⁰¹Tl scores, and were matched when all scores were the same. Left ventricular function was estimated using wall motion score. Sensitivity and regional wall motion were significantly better in mismatching ^99mTc-tetrofosmin-early/¹²³I-BMIPP segments than mismatching ²⁰¹Tl/¹²³I-BMIPP or ^99mTc-tetrofosmin-delayed/¹²³I-BMIPP segments. It is concluded that mismatching of ¹²³I-BMIPP and early ^99mTc-tetrofosmin uptake can predict improvement in wall motion of stunned myocardium better than the other two imaging combinations.