AIMS: The apical ballooning syndrome (ABS) is a new diagnostic entity which is increasingly recognized. Precise magnetic resonance imaging (MRI) data are not yet available and there is little evidence for the differential diagnosis of ABS assessed by MRI. METHODS AND RESULTS: Between January 2005 and January 2008, 6100 consecutive patients with diagnosis of acute coronary syndrome underwent left heart catheterization. In 59 patients (1.0%), coronary angiography revealed normal coronary arteries, but left ventriculography showed left ventricular dysfunction with apical ballooning. These 59 patients underwent cardiac MRI using a 1.5 T MRI scanner. In 13 patients (22.0%), MRI revealed diagnosis of myocardial infarction, in eight patients (13.6%) diagnosis of myocarditis. In all other 38 (64.4%) patients (36 female, age 73 +/- 10 years) with suspected ABS, no delayed enhancement or signs of inflammation were detected. Follow-up MRI after 3 months showed a completely normalized left ventricular ejection in all patients with suspected ABS. Similarly, the end-diastolic volume and end-systolic volume improved at follow-up. CONCLUSION: Cardiac MRI allows differentiating ABS from other rare causes with unobstructed coronary vessels such as myocarditis and coronary emboli with spontaneous lysis. Therefore, cardiac MRI can add valuable information in all patients with suspected ABS for further differential diagnosis.
AIMS: The apical ballooning syndrome (ABS) is a new diagnostic entity which is increasingly recognized. Precise magnetic resonance imaging (MRI) data are not yet available and there is little evidence for the differential diagnosis of ABS assessed by MRI. METHODS AND RESULTS: Between January 2005 and January 2008, 6100 consecutive patients with diagnosis of acute coronary syndrome underwent left heart catheterization. In 59 patients (1.0%), coronary angiography revealed normal coronary arteries, but left ventriculography showed left ventricular dysfunction with apical ballooning. These 59 patients underwent cardiac MRI using a 1.5 T MRI scanner. In 13 patients (22.0%), MRI revealed diagnosis of myocardial infarction, in eight patients (13.6%) diagnosis of myocarditis. In all other 38 (64.4%) patients (36 female, age 73 +/- 10 years) with suspected ABS, no delayed enhancement or signs of inflammation were detected. Follow-up MRI after 3 months showed a completely normalized left ventricular ejection in all patients with suspected ABS. Similarly, the end-diastolic volume and end-systolic volume improved at follow-up. CONCLUSION: Cardiac MRI allows differentiating ABS from other rare causes with unobstructed coronary vessels such as myocarditis and coronary emboli with spontaneous lysis. Therefore, cardiac MRI can add valuable information in all patients with suspected ABS for further differential diagnosis.
Authors: Ulrike M Müller; Ingo Eitel; Kristina Eckrich; Sandra Erbs; Axel Linke; Sven Möbius-Winkler; Meinhard Mende; Gerhard C Schuler; Holger Thiele Journal: Clin Res Cardiol Date: 2010-10-24 Impact factor: 5.460
Authors: Annamalai Senthilkumar; Maulik D Majmudar; Chetan Shenoy; Han W Kim; Raymond J Kim Journal: Heart Fail Clin Date: 2009-07 Impact factor: 3.179
Authors: Edouard Gerbaud; Emmanuel Harcaut; Pierre Coste; Matthew Erickson; Mathieu Lederlin; Jean Noel Labèque; Jean Marie Perron; Hubert Cochet; Pierre Dos Santos; Catherine Durrieu-Jaïs; François Laurent; Michel Montaudon Journal: Int J Cardiovasc Imaging Date: 2011-05-03 Impact factor: 2.357