Serial evaluation of left ventricular contraction and relaxation in Takotsubo cardiomyopathy by 2D speckle tracking echocardiography

Abstract

A 78-year-old woman was referred to our hospital because of general fatigue. The electrocardiogram showed ST elevation in the I, II, aVL, and V2-V6 leads. Echocardiography showed left ventricular apical akinesis. On emergent cardiac catheterization, left ventricular basal hyperkinesis and apical akinesis without coronary artery stenosis were found. The patient was diagnosed with Takotsubo cardiomyopathy. Two-dimensional myocardial speckle tracking echocardiography was performed on admission, the 8th hospital day, and the 15th hospital day. Gradual improvement in wall motion abnormality and longitudinal peak systolic strain, peak systolic strain rate, and early diastolic strain rate from the basal to apical region of the left ventricle were observed objectively, and she achieved remission. We herein report a case of Takotsubo cardiomyopathy in which objective improvement in left ventricular contraction and relaxation was observed by 2D speckle tracking imaging and bull's eye mapping.

An Extensive Review on Imaging Diagnosis Methods in Takotsubo Syndrome

“…2 ]. It is necessary to document the recovery of the ventricular systolic function –and the progression or regression of complications [ 54 , 78 ]. As diagnostic Takotsubo Criteria mention, the wall motion anomalies are transient [ 2 , 4 , 5 ].…”

“…Speckle tracking echography showed impaired of LV contraction and relaxation by analyzing peak systolic strain rate and early diastolic strain rate, which both improved over time [ 78 ].…”

Takotsubo Syndrome Versus Myocardial Infarction: what is the role of Echocardiography?

“…Two-dimensional speckle tracking echocardiography (2D STE) is a tool for quantitative assessment of myocardial function [13,[16][17][18]. Through measurement of myocardial strain, it has better reproducibility than tissue Doppler imaging strain and higher sensitivity in detecting subtle myocardial abnormalities [1,9], revealing myocardial dysfunction even before significant changes in LVEF and cardiac output [19].…”

“…In some patients with TTS, systolic anterior motion (SAM) and LV outflow tract obstruction (LVOTO) may develop as a result of LV basal wall hyperkinesis, occurring in about 10% to 25% [11,17,22] (Figure 4). It typically resolves with medical management and gradual ventricular recovery [11,22].…”