UNLABELLED: AIMS; Our study aims to investigate the pathophysiologic mechanism underlying tako-tsubo cardiomyopathy using F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET). METHODS AND RESULTS: Fifteen patients with tako-tsubo cardiomyopathy were enrolled in this study. Plasma catecholamines, cardiac troponin T (cTnT), and D-dimer were serially evaluated in all patients. Thallium-201 ((201)Tl) single-photon emission computed tomography (SPECT) and F-18 FDG PET were performed in 10 and eight patients, respectively. Emotional or physical stress occurred in 12 (80.0%) patients. ST-T segment abnormalities existed in all patients. Thirteen patients exhibited mildly elevated cTnT, although coronary angiography did not reveal significant stenosis in any patient. Endomyocardial biopsy specimens (n = 9) demonstrated contraction-band necrosis (n = 4) and mononuclear cell infiltration (n = 3). The levels of norepinephrine and epinephrine peaked on admission (744 +/- 452 and 140 +/- 166 pg/mL, respectively). There was severely reduced uptake at the apex on F-18 FDG PET image, despite slightly reduced uptake of (201)Tl. Elevation of D-dimer was observed in nine patients. CONCLUSION: The extent of metabolic defect involving apical akinetic area was more severe than perfusion abnormality. Our data suggest that sudden emotional or physical stress may cause a catecholamine-induced metabolic disorder in the myocardium, which is probably central to this syndrome.
UNLABELLED: AIMS; Our study aims to investigate the pathophysiologic mechanism underlying tako-tsubo cardiomyopathy using F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET). METHODS AND RESULTS: Fifteen patients with tako-tsubo cardiomyopathy were enrolled in this study. Plasma catecholamines, cardiac troponin T (cTnT), and D-dimer were serially evaluated in all patients. Thallium-201 ((201)Tl) single-photon emission computed tomography (SPECT) and F-18FDG PET were performed in 10 and eight patients, respectively. Emotional or physical stress occurred in 12 (80.0%) patients. ST-T segment abnormalities existed in all patients. Thirteen patients exhibited mildly elevated cTnT, although coronary angiography did not reveal significant stenosis in any patient. Endomyocardial biopsy specimens (n = 9) demonstrated contraction-band necrosis (n = 4) and mononuclear cell infiltration (n = 3). The levels of norepinephrine and epinephrine peaked on admission (744 +/- 452 and 140 +/- 166 pg/mL, respectively). There was severely reduced uptake at the apex on F-18FDG PET image, despite slightly reduced uptake of (201)Tl. Elevation of D-dimer was observed in nine patients. CONCLUSION: The extent of metabolic defect involving apical akinetic area was more severe than perfusion abnormality. Our data suggest that sudden emotional or physical stress may cause a catecholamine-induced metabolic disorder in the myocardium, which is probably central to this syndrome.
Authors: Jelena R Ghadri; Svetlana Dougoud; Willibald Maier; Philipp A Kaufmann; Oliver Gaemperli; Abhiram Prasad; Thomas F Lüscher; Christian Templin Journal: Int J Cardiovasc Imaging Date: 2013-10-22 Impact factor: 2.357
Authors: Thomas Emil Christensen; Lia Evi Bang; Lene Holmvang; Adam Ali Ghotbi; Martin Lyngby Lassen; Flemming Andersen; Nikolaj Ihlemann; Hedvig Andersson; Peer Grande; Andreas Kjaer; Philip Hasbak Journal: Int J Cardiovasc Imaging Date: 2014-05-23 Impact factor: 2.357
Authors: A Duran-Cambra; M Sutil-Vega; M Fiol; I J Núñez-Gil; M Vila; J Sans-Roselló; J Cinca; A Sionis Journal: Ann Noninvasive Electrocardiol Date: 2014-11-04 Impact factor: 1.468