心筋BMIPPシンチグラフィ：中性脂肪蓄積心筋血管症（TGCV）での臨床使用

Myocardial BMIPP scintigraphy：clinical utility in triglyceride deposit cardiomyovasculopathy（TGCV）

脂肪酸の放射性アナログとして開発された15-（4-ヨードフェニル）-3（R,S）-メチルペンタデカン酸（¹²³I）（¹²³I-BMIPP，以下BMIPP）の臨床使用開始から30年が経過した。

For over 30 years, ¹²³I-BMIPP has been a pivotal tool for detecting abnormalities in fatty acid metabolism within cardiomyocytes, especially in cases of ischemic myocardial injury. With the emergence of the novel disease concept, triglyceride deposit cardiomyovasculopathy （TGCV）, previously unrecognized aspects of BMIPP scintigraphy have come to light, expanding its clinical applications. TGCV is a rare intractable disorder characterized by intracellular triglyceride （TG） accumulation due to impaired TG lipolysis, leading to heart failure, arrhythmia, and coronary atherosclerosis. Despite normal serum TG levels, patients with TGCV exhibit intracellular TG accumulation in cardiomyocytes and vascular smooth muscle cells. BMIPP scintigraphy detects this abnormality by assessing washout rates （WR）, where a rate below 10% constitutes an essential diagnostic criterion. This article elucidates the core diagnostic principles of TGCV using BMIPP WR and underscores its role as an invaluable clinical indicator.