Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using99mTc-tetrofosmin,123I-BMIPP,123I-MIBG and99mTc-PYP myocardial SPECT

Ito, Kazuki; Sugihara, Hiroki; Kinoshita, Noriyuki; Azuma, Akihiro; Matsubara, Hiroaki

doi:10.1007/bf02985570

Cited by 98 publications

(9 citation statements)

References 28 publications

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“…A follow-up observation study using 201 Tl, 123 IBMIPP, 123 I-MIBG SPECT showed that the recovery of the decreased uptake mostly occurred in the order of 201Tl, 123I-BMIPP, and 123I-MIBG. [23][24][25] Moreover, Suzuki et al have measured regional cerebral blood flow, a well-established index of brain activity using 99m Tc ethyl cysteinate dimmer SPECT, and demonstrated a significant cerebral blood flow increase in the hippocampus, brainstem, and basal ganglia paralleled by a decrease in the prefrontal cortex in the acute phase of TTC. 26 Although these changes gradually subsided, they were still present in the chronic phase of TTC even after the cardiac wall motion abnormalities had disappeared.…”

Section: Discussionmentioning

confidence: 99%

Serial changes of myocardial perfusion imaging in takotsubo and reverse takotsubo cardiomyopathy

Miyajima

Tawarahara

Saito³

2022

Journal of Nuclear Cardiology

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Background Takotsubo cardiomyopathy (TTC) shows reversible hypokinesis in the left ventricular (LV) apical-half segment and hyperkinesis in the LV basal-half segment. However, the precise pathophysiological mechanism of TTC is unclear. Therefore, this study sought to clarify the nuclear characteristics, degree of myocardial damage, and serial change of TTC and rTTC using myocardial perfusion imaging. Methods We performed myocardial perfusion scintigraphy in 28 patients (TTC: 20, rTTC: 8) using Tc-99m sestamibi and assessed minimum percentage uptake (min-%-uptake), extent score (ES) and summed rest score (SRS) at acute and chronic phases. Results Min-%-uptake improved from the acute to the chronic phase (TTC: 54 [48-59]% vs 87 [81-90]%, P < 0.01; rTTC: 60 [55-64]% vs 77 [71-79]%, P < 0.01), as did the ES (TTC: 32 [26-41]% vs 0.0 [0.0-6.0]%, P < 0.01; rTTC: 16 [12-34]% vs 0.0 [0.0-0.0]%, P = 0.02) and SRS (TTC: 4.5 [3.9-5.3] vs 0.0 [0.0-0.2], P < 0.01; rTTC: 3.6 [3.3-3.8] vs 0.0 [0.0-0.0], P = 0.01). Conclusion Tc-99m sestamibi uptake was reduced in hypokinetic regions in the acute phase and improved in the chronic phase. TTC and rTTC may involve a reversible disorder of the myocardial cell membrane, mitochondria, and microcirculation.

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Section: Discussionmentioning

confidence: 99%

Serial changes of myocardial perfusion imaging in takotsubo and reverse takotsubo cardiomyopathy

Miyajima

Tawarahara

Saito³

2022

Journal of Nuclear Cardiology

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“…Myocardial perfusion imaging during the acute phase typically demonstrates normal or mildly reduced uptake in the dysfunctional segments. Normalisation of uptake occurs in association with wall motion recovery 79,80 …”

Section: Diagnosismentioning

confidence: 99%

Takotsubo syndrome in New Zealand: current knowledge and future challenges

Looi

Chan

Bridgman

et al. 2022

Internal Medicine Journal

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Takotsubo syndrome (TS), also known as apical ballooning syndrome, is a transient stress-related cardiomyopathy characterised by acute but reversible left ventricular dysfunction. The condition tends to occur in postmenopausal women after a stressful event. At presentation, TS typically mimics acute myocardial infarction (MI) and the incidence of TS has been increasing worldwide. This is likely a consequence of an improved awareness of the existence of this syndrome and easier access to early echocardiography and coronary angiography. However, its aetiology remains poorly understood and it is probably still underdiagnosed. Similar to other countries, TS is being increasingly recognised in New Zealand. In this review, we discuss the demographics, clinical features and outcomes of patients with TS in New Zealand. Doing so informs us not only of the pattern of disease in New Zealand but it also provides insights into the condition itself.

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“…However, cases of TS with delayed gadolinium uptake have been reported [133], giving rise to doubts of ischemia. Myocardial SPECT reveals a fall in technetium-99m tetrofosmin uptake in the acute phase, indicative of a decrease in myocardial perfusion [100,135,136]. Reversible alterations of a number of radioactive tracers, such as 123 I-BMIPP and 123 I-MIBG, could indicate a reduction in fatty acid and glucose metabolism, alterations of coronary microcirculation, or a possible imbalance in the sympathetic innervation between the apical and basal regions [137].…”

Section: Imaging Studiesmentioning

confidence: 99%

Takotsubo cardiomyopathy – a clinical review

2011

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SummaryStress cardiomyopathy is characterised by reversible left ventricular dysfunction. It simulates an acute coronary syndrome (ACS), presenting with precordial pain or dyspnoea, changes of the ST segment, T wave, or QTc interval on electrocardiogram, and raised cardiac enzymes. Typical findings are disturbances of segmental contractility (apical hypokinesia or akinesia), with normal epicardial coronary arteries. The true prevalence is unknown, as the syndrome may be under-diagnosed; it is more common in postmenopausal women. There is usually a trigger in the form of physical or psychological stress. The electrocardiographic, echocardiographic, and ventriculographic changes resolve spontaneously over a variable period of time (from days to months). There are a number of pathophysiological theories, none of which has been shown to be definitive, suggesting that all of them may be involved to some extent. The prognosis is generally favourable, and recurrence is very rare.

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Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using99mTc-tetrofosmin,123I-BMIPP,123I-MIBG and99mTc-PYP myocardial SPECT

Abstract: Takotsubo cardiomyopathy might represent a stunned myocardium caused by a disturbance of the coronary microcirculation.

Cited by 98 publications

References 28 publications

Serial changes of myocardial perfusion imaging in takotsubo and reverse takotsubo cardiomyopathy

Serial changes of myocardial perfusion imaging in takotsubo and reverse takotsubo cardiomyopathy

Takotsubo syndrome in New Zealand: current knowledge and future challenges

Takotsubo cardiomyopathy – a clinical review

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