Yukari Kobayashi1,2, Hiroyuki Okura3, Yuhei Kobayashi1,2, Shuichiro Fukuda1, Atsushi Hirohata1, Kiyoshi Yoshida1. 1. Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan. 2. Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. 3. First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
Abstract
BACKGROUND: We aimed to investigate left ventricular (LV) functional recovery in Takotsubo cardiomyopathy (TC) using three-dimensional (3D) speckle tracking echocardiography. METHODS: Twenty-one patients with TC who underwent routine and 3D echocardiography as well as electrocardiography were enrolled. 3D images were analyzed to measure 3D radial strain and area tracking (area change of each LV segment). Postsystolic shortening (PSS) or thickening (PST) was defined as a further shortening or thickening occurred after the end-systole. 3D echocardiography and ECG were repeated at 4 weeks and 6 months later. RESULTS: Mean age was 70.9±11.1 years, and 18 (86%) patients were female. All patients presented classical type of TC with apical ballooning. LV ejection fraction (EF) improved from 49.9±7.2 to 64.9±6.0% (P<.001) at 4 weeks without segmental wall-motion abnormality. However, PSS or PST still existed in 43% of LV segments, and electrocardiographic abnormality was also observed in 51% at 4 weeks and disappeared at 6 months. Mean 3D radial strain decreased from baseline to 6 months at base (36.1±19.6 vs 28.0±12.6%, P=.04), whereas it increased at mid (16.2±7.2 vs 28.7±9.1%, P=.03) and the apex (8.0±4.4 vs 21.2±7.9%, P<.001). Mean area tracking increased from baseline to 6 months at mid and apex (-28.5±9.5 vs -44.5±9.6%, P<.001 for mid, and -24.2±13.0 vs -42.9±16.8%, P=.002 for the apex), while it did not change at base (-37.0±8.9 vs -41.9±9.6%, P=NS). CONCLUSIONS: Patients with TC show abnormal wall motion during acute phase. Even after LV wall-motion recovery, subtle abnormalities of regional LV function appear to persist at 4 weeks followed by normalization at 6 months.
BACKGROUND: We aimed to investigate left ventricular (LV) functional recovery in Takotsubo cardiomyopathy (TC) using three-dimensional (3D) speckle tracking echocardiography. METHODS: Twenty-one patients with TC who underwent routine and 3D echocardiography as well as electrocardiography were enrolled. 3D images were analyzed to measure 3D radial strain and area tracking (area change of each LV segment). Postsystolic shortening (PSS) or thickening (PST) was defined as a further shortening or thickening occurred after the end-systole. 3D echocardiography and ECG were repeated at 4 weeks and 6 months later. RESULTS: Mean age was 70.9±11.1 years, and 18 (86%) patients were female. All patients presented classical type of TC with apical ballooning. LV ejection fraction (EF) improved from 49.9±7.2 to 64.9±6.0% (P<.001) at 4 weeks without segmental wall-motion abnormality. However, PSS or PST still existed in 43% of LV segments, and electrocardiographic abnormality was also observed in 51% at 4 weeks and disappeared at 6 months. Mean 3D radial strain decreased from baseline to 6 months at base (36.1±19.6 vs 28.0±12.6%, P=.04), whereas it increased at mid (16.2±7.2 vs 28.7±9.1%, P=.03) and the apex (8.0±4.4 vs 21.2±7.9%, P<.001). Mean area tracking increased from baseline to 6 months at mid and apex (-28.5±9.5 vs -44.5±9.6%, P<.001 for mid, and -24.2±13.0 vs -42.9±16.8%, P=.002 for the apex), while it did not change at base (-37.0±8.9 vs -41.9±9.6%, P=NS). CONCLUSIONS:Patients with TC show abnormal wall motion during acute phase. Even after LV wall-motion recovery, subtle abnormalities of regional LV function appear to persist at 4 weeks followed by normalization at 6 months.
Authors: Sören J Backhaus; Thomas Stiermaier; Torben Lange; Amedeo Chiribiri; Pablo Lamata; Johannes Uhlig; Johannes T Kowallick; Uwe Raaz; Adriana Villa; Joachim Lotz; Gerd Hasenfuß; Holger Thiele; Ingo Eitel; Andreas Schuster Journal: Int J Cardiol Date: 2018-04-22 Impact factor: 4.164
Authors: Brent Gudenkauf; Allison G Hays; Jacqueline Tamis-Holland; Jeffrey Trost; Daniel I Ambinder; Katherine C Wu; Armin Arbab-Zadeh; Roger S Blumenthal; Garima Sharma Journal: J Am Heart Assoc Date: 2021-12-31 Impact factor: 6.106