Ergebnisse der Fettsäure-SPECT des Myokards bei der koronaren Herzerkrankung

New developments in radiopharmacology of ¹²³l-labeled metabolic tracers and single-photon emission computerized tomography (SPECT) allow now-a-days the assessment of parameters of cardiac energy metabolism in well-defined areas of the heart muscle. This article will present a brief outline of the basic pathophysiological principles used in the application of ¹²³l-labeled phenyl fatty acids for the evaluation of CAD. First clinical results suggest an important application of cardiac fatty acid metabolic imaging to the detection, localisation and conceivable quantitation of myocardial ischemia, myocardial infarction and assessment of tissue viability. In addition to the diagnostic applications in CAD, cardiac fatty acid metabolic imaging may provide new perspectives to pathophysiological investigations of the coupling of local flow and substrate utilisation in vivo and the effect of therapeutic interventions.

Zusammenfassung

Neue Entwicklungen in der Radiopharmakologie ¹²³J-markierter myokardaffiner Stoffwechsel-Tracer und die Single-Photon-Emissions-Computer-Tomographie haben die Untersuchung von Parametern des myokardialen Energiestoffwechsels in definierten Arealen des Herzmuskels möglich gemacht. Die vorliegende Arbeit gibt einen kurzen Abriß über pathophysiologische Prinzipien und Grundlagen der Anwendung ¹²³J-markierter Fettsäuren in der Diagnostik der koronaren Herzerkrankung in Verbindung mit SPECT. Erste klinische Ergebnisse zeigen die Möglichkeit des Nachweises, der Lokalisation und vielleicht auch der Quantifizierung des Myokardinfarktes, der reversiblen Myokardischämie sowie des Nachweises der Gewebsvitalität. Neben der Anwendung in der Diagnostik der koronaren Herzerkrankung eröffnet das geschilderte Untersuchungsverfahren neue Perspektiven für pathophysiolo- gische Untersuchungen der Koppelung von Fluß und Stoffwechsel des Herzmuskels und deren therapeutische Beeinflußbarkeit in einem Untersuchungsgang.

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