Six-Month Follow-Up of Takotsubo Cardiomyopathy with I-123-.BETA.-Metyl-Iodophenyl Pentadecanoic Acid and I-123-Meta-Iodobenzyl-Guanidine Myocardial Scintigraphy.

Abstract

A 69-year-old man with a history of transient chest pain was diagnosed takotsubo cardiomyopathy. In I-123-(3-metyliodophenyl pentadecanoic acid myocardial scintigraphy, decreased uptake of apex was seen in the acute phase, and it recovered in 3 months. In I-123-meta-iodobenzyl-guanidine myocardial scintigraphy, decreased uptake of apex persisted for 6 months, and there was a discrepancy between apical and total washout rate in the acute phase and after 3 months, which disappeared after 6 months. We speculate that the discrepancy of sympathetic innervation between the apical and basal region is the cause of the characteristic left ventricular apical akinesia of takotsubo cardiomyopathy. (Internal Medicine 41: 829-833, 2002)

Takotsubo (Ampulla-shaped) Cardiomyopathy Associated with Microscopic Polyangiitis

“…It may be explained by myocardial injury due to MPA, a myocardial perfusion defect (16), cardiac sympathetic hyperactivity (17,18), or an impaired myocardial fatty acid metabolism (19) in the apical myocardial wall. The pathological examinations of myocardial muscle and the scintigraphic studies of myocardial per- fusion, cardiac sympathetic activity, and fat metabolism will elucidate its cause in MPA or PN in the future.…”

Transient left ventricular dysfunction (tako-tsubo phenomenon): Findings and potential pathophysiological mechanisms

“…The idea that TTP is related to a disturbance of cardiac sympathetic innervation is supported by scintigraphic findings. Perfusion defects in the anteroseptal wall are detected by thallium-201 ( 201 Tl) myocardial scintigraphy without technetium-99m pyrophosphate uptake in the matching area; extensive perfusion defects are also detected around the apex by 123 iodine metaiodobenzylguanidine scintigraphy (42,44,46,47,55,(62)(63)(64). When assessed semiquantitatively, the metaiodobenzylguanidine images had higher defect scores than those with 201 Tl scintigraphy during the acute phase, as well as throughout the following year.…”

Síndrome de Tako-Tsubo: caso clínico

“…Respecto a una eventual persistencia de las alteraciones segmentarias, en relación a disturbios de catecolaminas, existe evidencia de alteración apical precoz y hasta 6 meses mediante imágenes con metayodobenzilguanidina marcada 19 . En pacientes con STT sometidos a estrés mental, al menos 1 mes post inicio del cuadro, se demostró dilatación post-estrés y alteraciones de motilidad segmentaria transitoria en la mayoría de los casos con STT respecto a grupo control, sin alteraciones coronarias 20 .…”