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Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study

Background: The wall motion abnormalities of the left ventricle (LV) in takotsubo syndrome (TTS) are known to be transient and completely recover within a few weeks. However, there is little information about the relationship between functional recovery and tissue characteristics. The aim of this st...

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Autores principales: Kato, Ken, Daimon, Michiko, Sano, Masanori, Matsuno, Koki, Sakai, Yoshiaki, Ishibashi, Iwao, Kadohira, Tadayuki, Matsumoto, Koji, Masuda, Yoshitada, Uno, Takashi, Ghadri, Jelena-Rima, Templin, Christian, Kobayashi, Yoshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878106/
https://www.ncbi.nlm.nih.gov/pubmed/35207260
http://dx.doi.org/10.3390/jcm11040987
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author Kato, Ken
Daimon, Michiko
Sano, Masanori
Matsuno, Koki
Sakai, Yoshiaki
Ishibashi, Iwao
Kadohira, Tadayuki
Matsumoto, Koji
Masuda, Yoshitada
Uno, Takashi
Ghadri, Jelena-Rima
Templin, Christian
Kobayashi, Yoshio
author_facet Kato, Ken
Daimon, Michiko
Sano, Masanori
Matsuno, Koki
Sakai, Yoshiaki
Ishibashi, Iwao
Kadohira, Tadayuki
Matsumoto, Koji
Masuda, Yoshitada
Uno, Takashi
Ghadri, Jelena-Rima
Templin, Christian
Kobayashi, Yoshio
author_sort Kato, Ken
collection PubMed
description Background: The wall motion abnormalities of the left ventricle (LV) in takotsubo syndrome (TTS) are known to be transient and completely recover within a few weeks. However, there is little information about the relationship between functional recovery and tissue characteristics. The aim of this study was to investigate the recovery process of TTS using cardiovascular magnetic resonance (CMR). Methods: Consecutive patients with TTS were prospectively enrolled. We performed serial CMR in the acute phase (<72 h after admission), the subacute phase (7–10 days after admission) and the chronic phase (3 months later). To assess the degree of myocardial edema quantitatively, we evaluated the signal intensity of myocardium on T2-weighted images and calculated the signal intensity ratio compared with the skeletal muscle. Results: Fifteen patients with TTS were enrolled. CMR demonstrated reduced LV ejection fraction in the acute phase, and it recovered almost completely by the subacute phase. On the other hand, severe myocardial edema was still observed in the subacute phase, associated with increased LV mass. The highest signal intensity ratio in the subacute phase was correlated with the maximum voltage of negative T wave on electrocardiogram (r = 0.57, p = 0.03). Conclusions: In patients with TTS, myocardial edema associated with increased LV mass still remained in the subacute phase despite functional recovery of the LV. Electrocardiogram may be useful to assess the degree of myocardial edema in the subacute phase. Our study suggests that myocardial ischemia might have a central role in developing TTS.
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spelling pubmed-88781062022-02-26 Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study Kato, Ken Daimon, Michiko Sano, Masanori Matsuno, Koki Sakai, Yoshiaki Ishibashi, Iwao Kadohira, Tadayuki Matsumoto, Koji Masuda, Yoshitada Uno, Takashi Ghadri, Jelena-Rima Templin, Christian Kobayashi, Yoshio J Clin Med Article Background: The wall motion abnormalities of the left ventricle (LV) in takotsubo syndrome (TTS) are known to be transient and completely recover within a few weeks. However, there is little information about the relationship between functional recovery and tissue characteristics. The aim of this study was to investigate the recovery process of TTS using cardiovascular magnetic resonance (CMR). Methods: Consecutive patients with TTS were prospectively enrolled. We performed serial CMR in the acute phase (<72 h after admission), the subacute phase (7–10 days after admission) and the chronic phase (3 months later). To assess the degree of myocardial edema quantitatively, we evaluated the signal intensity of myocardium on T2-weighted images and calculated the signal intensity ratio compared with the skeletal muscle. Results: Fifteen patients with TTS were enrolled. CMR demonstrated reduced LV ejection fraction in the acute phase, and it recovered almost completely by the subacute phase. On the other hand, severe myocardial edema was still observed in the subacute phase, associated with increased LV mass. The highest signal intensity ratio in the subacute phase was correlated with the maximum voltage of negative T wave on electrocardiogram (r = 0.57, p = 0.03). Conclusions: In patients with TTS, myocardial edema associated with increased LV mass still remained in the subacute phase despite functional recovery of the LV. Electrocardiogram may be useful to assess the degree of myocardial edema in the subacute phase. Our study suggests that myocardial ischemia might have a central role in developing TTS. MDPI 2022-02-14 /pmc/articles/PMC8878106/ /pubmed/35207260 http://dx.doi.org/10.3390/jcm11040987 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kato, Ken
Daimon, Michiko
Sano, Masanori
Matsuno, Koki
Sakai, Yoshiaki
Ishibashi, Iwao
Kadohira, Tadayuki
Matsumoto, Koji
Masuda, Yoshitada
Uno, Takashi
Ghadri, Jelena-Rima
Templin, Christian
Kobayashi, Yoshio
Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title_full Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title_fullStr Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title_full_unstemmed Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title_short Dynamic Trend of Myocardial Edema in Takotsubo Syndrome: A Serial Cardiac Magnetic Resonance Study
title_sort dynamic trend of myocardial edema in takotsubo syndrome: a serial cardiac magnetic resonance study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8878106/
https://www.ncbi.nlm.nih.gov/pubmed/35207260
http://dx.doi.org/10.3390/jcm11040987
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