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. 2014 Feb 28;3(1):e000473. doi: 10.1161/JAHA.113.000473

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© 2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Figure 4. — SPECT myocardial metabolism/perfusion imaging for the assessment of at‐risk myocardium. Diagram depicting combined fatty acid SPECT metabolic imaging with ¹²³I‐BMIPP and technetium‐based SPECT perfusion imaging with ^99mTc‐sestamibi/tetrofosmin for the assessment of myocardial salvage in 2 different hypothetical examples of acute ischemic myocardial injury in the left anterior descending (LAD) coronary artery territory. This technique requires injections of 2 separate radiotracers (¹²³I‐BMIPP and ^99mTc‐sestamibi/tetrofosmin) following reperfusion. A, Post‐reperfusion ¹²³I‐BMIPP SPECT imaging reveals an area of decreased counts in the anteroseptum and anterior wall, whereas post‐reperfusion ^99mTc‐sestamibi/tetrofosmin SPECT imaging shows normal myocardial perfusion. These findings suggest significant myocardial salvage in the left anterior descending coronary artery territory. B, Both post‐reperfusion ¹²³I‐BMIPP SPECT metabolic imaging and post‐reperfusion ^99mTc‐sestamibi/tetrofosmin perfusion SPECT imaging demonstrate decreased counts in the anteroseptum and anterior wall, suggesting no myocardial salvage in the left anterior descending coronary artery territory. ¹²³I‐BMIPP indicates β‐methyl‐p‐[¹²³I]‐iodophenyl‐pentadecanoic acid; ^99mTc, technetium‐99m; MI, myocardial infarction; SPECT, single‐photon emission computed tomography.