A Case of Hypertensive-Diabetic Cardiomyopathy Demonstrating Left Ventricular Wall Motion Abnormality
- Tsuyoshi Shimonagata, MD,
- Shinsuke Nanto, MD,
- Masakazu Hori, MD,
- Tomoki Ohara, MD,
- Youngjoon Kim, MD,
- Yuzuru Takano, MD,
- Ken'ya Sakamoto, MD,
- Keiji Kamado, MD,
- Syujiro Kubori, MD,
- Hideo Kusuoka, MD and
- Tsunehiko Nishimura, MD
- Department of Internal Medicine, Kansai Rosai Hospital Hyogo
- First Department of Internal Medicine, Biomedical Research Center, Osaka University Medical School Osaka, Japan
- Osaka University School of Medicine; and Tracer Kinetics, Biomedical Research Center, Osaka University Medical School Osaka, Japan
- Address correspondence and reprint requests to Tsuyoshi Shimonagata, MD, Department of Internal Medicine, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660, Japan.
Abstract
We report a case of hypertensive-diabetic cardiomyopathy demonstrating left ventricular regional wall motion abnormality, with a normal coronary artery documented on coronary arteriography. Dipyridamole-infusion 201Tl scintigraphy demonstrated transient perfusion defects in the infero-posterior wall of the left ventricle, where reduced wall motion was demonstrated on contrast left ventriculography. Myocardial SPECT (single photon emission tomography) imaging with [123I] β-methyliodophenylpentadecanoic acid (BMIPP) and 201Tl demonstrated reduced [123I]BMIPP uptake compared with 201Tl uptake in the infero-posterior wall of left ventricle. These results suggest that the impairment of myocardial free fatty acid metabolism is an etiologic or contributory factor for regional wall motion abnormality, together with small-vessel coronary artery disease, in this patient.
- Received May 26, 1995.
- Revision received October 26, 1995.
- Accepted October 26, 1995.
- Copyright © 1996 by the American Diabetes Association
