Fatty Acid Metabolism in Symptomatic Patients with Mitral Valve Prolapse but without Coronary Artery Disease - Comparison with 201 Tl Myocardial Perfusion Scintigraphy
Using 123l-ω-heptadecanoic acid (HDA) and 201TI, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination halflife was 26.1 ± 3.6 min, whereas the patients with MVP had a mean value of ± 6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31 % and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201TI showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201TI, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism.