Discrepant myocardial microvascular perfusion and mechanics after acute myocardial infarction: Characterization of the “Tako-tsubo effect” with real-time myocardial perfusion contrast echocardiograph

Qiu, Qiong; Abdelghany, Mahmoud; Subedi, Rogin; Scalzetti, Ernest M.; Feiglin, David; Wang, Jingfeng; Liu, Kan

doi:10.1016/j.ijcard.2018.09.114

Cited by 9 publications

(11 citation statements)

References 47 publications

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“…Furthermore, evidence is accumulating that acute MI itself can trigger TTS. 4–9 In patients with acute MI, pain and other stressors can stimulate central and autonomic nervous systems and increase bioavailability of cortisol and circulating catecholamines, 2 , 3 affecting the myocardium supported by both culprit and non-culprit coronary arteries. 18 , 19 Due to a higher density of β-adrenergic receptors and higher proportion of β2 receptors linked to Gi than Gs proteins in the ventricular apex, 20 , 21 wall motion impairment may predominantly present in apical and middle segments of the ventricle.…”

Section: Discussionmentioning

confidence: 99%

“…Patients were excluded if they had primary valvular disorders, significant pulmonary hypertension, anomalous LAD origin, or if segmental wall motion could not be accurately determined by either left ventriculography (LVG) or transthoracic echocardiography. We identified TTE by integrating invasive and noninvasive protocols 4 based on coronary angiography (CAG), LVG, and transthoracic echocardiography. We compared demographic data, clinical presentations, coronary artery anatomies, myocardial deformation, systolic and diastolic ventricular functions, hemodynamic consequences, short-term (30-day) adverse cardiac events, and long-term (five-year) cardiac outcomes between patients with and without TTE.…”

Section: Patient Selectionmentioning

confidence: 99%

“…1 There is mounting evidence that acute MI-induced stressors can stimulate the central and autonomic nervous systems, increase circulating catecholamines, 2 , 3 and cause TTS. 4–9 By combining both invasive and non-invasive approaches, we recently characterized the imaging features of acute MI-induced TTS (“Takotsubo effect” (TTE)). 4 Here, we investigated the hemodynamic consequences and long-term prognosis of TTE in patients with anterior wall ST-segment elevation MI (STEMI).…”

Section: Introductionmentioning

confidence: 99%

“…4–9 By combining both invasive and non-invasive approaches, we recently characterized the imaging features of acute MI-induced TTS (“Takotsubo effect” (TTE)). 4 Here, we investigated the hemodynamic consequences and long-term prognosis of TTE in patients with anterior wall ST-segment elevation MI (STEMI).…”

Section: Introductionmentioning

confidence: 99%

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“Takotsubo effect” in patients with ST segment elevation myocardial infarction

Liu

Chen

Dogra

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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Background Myocardial infarction can be a trigger of Takotsubo syndrome. We recently characterized imaging features of acute myocardial infarction-induced Takotsubo syndrome (“Takotsubo effect”). In this study, we investigate diagnostic and prognostic implications of Takotsubo effect in patients with anterior wall ST-segment elevation myocardial infarction. Methods We enrolled 111 consecutive patients who developed anterior wall ST-segment elevation myocardial infarction and received percutaneous coronary intervention, and studied systolic/diastolic function, hemodynamic consequences, adverse cardiac events, as well as 30-day and five-year outcomes in patients with and without Takotsubo effect. Results Patients with Takotsubo effect showed significantly worse average peak systolic longitudinal strain (–9.5 ± 2.6% vs –11.1 ± 3.6%, p = 0.038), left ventricular ejection fraction (38.5 ± 6.8% vs 47.7 ± 8.7%, p = 0.000) and myocardial performance index (0.54 ± 0.17 vs 0.37 ± 0.15, p = 0.000) within 48 h of myocardial infarction. There was no significant difference between the two groups in diastolic ventricular filling pressures, hemodynamic consequences, and 30-day rehospitalization and mortality (Gehan-Breslow-Wilcoxon test: p = 0.157). However, patients with Takotsubo effect developed more major adverse cardiac events (log-rank test: p = 0.019) when tested at the five-year follow-up. Cox regression analysis revealed that age, hypotension, tricuspid annular plane systolic excursion, and Takotsubo effect were independent prediction factors for five-year major adverse cardiac events. The Doppler/tissue Doppler parameter E/e’ correlated with MACE only in patients without Takotsubo effect. Conclusion Takotsubo effect secondary to anterior ST-segment elevation myocardial infarction predicts a worse long-term prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

“Takotsubo effect” in patients with ST segment elevation myocardial infarction

Liu

Chen

Dogra

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…For example, it has been demonstrated that diabetes, high-density lipoprotein levels and triglyceride levels have more impact on cardiovascular health of women compared to men. [30] The emerging literature around Takotsubo cardiomyopathy with a predominance of women affected [31] is notable when considering the small, but intriguing, increase in deaths due to heart failure in women, but not men, at Christmas.…”

Section: Discussionmentioning

confidence: 99%

Unwrapping the Surprisingly High Risk of Dying from Cardiovascular Disease at Christmas: The HUNT Prospective Population-based Cohort Study in Norway

Moholdt

Afoakwah

Scuffham

et al. 2020

Preprint

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BackgroundAlthough it is known that winter inclusive of the Christams holiday period is associated with an increased risk of dying compared to other times of the year, very few studies have specifically examined this phenomenon within a population cohort subject to baseline profiling and prospective follow-up. In such a cohort, we sought to determine the specific characteristics of mortality occuring during the Christmas holidays. MethodsBaseline profiling and outcome data were derived from a prospective population-based cohort with longitudinal follow-up in Central Norway - the Nord-Trøndelag Health Study. From 1984-1986, 88% of the target population comprising 39,273 men and 40,353 women aged 48±18 and 50±18 years, respectively, were profiled. We examined the long-term pattern of all-cause mortality and specific causes of death according to season, month and individual days of the year to determine the number of excess (cause-specific) deaths occuring at key timepoints (including the Christmas holidays). ResultsDuring 33.5 (IQR 17.1-34.4) years follow-up, 19,879 (50.7%) men and 19,316 (49.3%) women died at age-adjusted rate of 5.3 and 4.6 deaths per 1000/annum, respectively. Each winter, there were 44 (95% CI 43-45) more all-cause deaths compared to summer, with 21 (95% CI 20-22) more deaths attributable to cardiovascular disease. Compared to any other time of the year, December 25th-27th was the deadliest; being associated with an excess of 1.3 (95% CI 1.1-1.5) all-cause and 1.0 (95% CI 0.7-1.3) cardiovascular-related deaths per day each year. Compared to the pre-Christmas/Winter period (1st-21st December), the incidence rate ratio of all-cause mortality increased to 1.22 (95% CI 1.16-1.27) and 1.17 (95% 1.11-1.22) in men and women, respectively, in the next 21 days (Christmas/New Year holiday period). All observed differences were highly significant (P<0.001). A less pronounced pattern of seasonally-linked deaths attributable to respiratory illnesses (but not cancer) was also observed.ConclusionChristmas in Central Norway is characterised by a distinctive change and increase in cardiovascular-related mortality over and above that observed between winter (more deaths) and summer (fewer deaths). This distinctive pattern contrasted with cancer-related deaths. Further research to address vulnerability to the darker consequences of winter and, more specifically Christmas, is required.

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Surveillance of adenosine stress myocardial contrast echocardiography following percutaneous coronary intervention

Kim

Hwang

et al. 2022

Int J Cardiovasc Imaging

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Discrepant myocardial microvascular perfusion and mechanics after acute myocardial infarction: Characterization of the “Tako-tsubo effect” with real-time myocardial perfusion contrast echocardiograph

Cited by 9 publications

References 47 publications

“Takotsubo effect” in patients with ST segment elevation myocardial infarction

“Takotsubo effect” in patients with ST segment elevation myocardial infarction

Unwrapping the Surprisingly High Risk of Dying from Cardiovascular Disease at Christmas: The HUNT Prospective Population-based Cohort Study in Norway

Surveillance of adenosine stress myocardial contrast echocardiography following percutaneous coronary intervention

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