Tako-Tsubo Transient Left Ventricular Apical Ballooning Is Associated With a Left Anterior Descendig Coronary Artery With a Long Course Along the Apical Diaphragmatic Surface of the Left Ventricle

Ibáñez, Borja; Navarro, Felipe; Farré, Jerónimo; Marcos‐Alberca, Pedro; Orejas, Miguel; Rábago, Rosa; Rey, Manuel; Romero, José R.; Íñiguez, Andrés; Córdoba, Manuel Benabent Fernández de

doi:10.1016/s1885-5857(06)60138-2

Cited by 19 publications

(14 citation statements)

References 15 publications

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“…In the occasional patient, the TTC apical ballooning pattern is similar to the contraction abnormality caused by ischemia from significant LAD coronary artery stenosis, which extends beyond the LV apex to supply the inferior wall ("wrap-around" LAD). 53 The mid-ventricular ballooning pattern (Figure 4), in which the mid-LV is akinetic, with normal apical and basal contraction, is present in approximately 25% of patients. 7, 51 The basal ballooning pattern (Figure 4) is rare and encountered in only 1%.…”

Section: Ventricular Contraction Patternsmentioning

confidence: 99%

Epidemiology and Clinical Profile of Takotsubo Cardiomyopathy

Sharkey

Maron

2014

Circ J

110

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Section: Ventricular Contraction Patternsmentioning

confidence: 99%

Epidemiology and Clinical Profile of Takotsubo Cardiomyopathy

Sharkey

Maron

2014

Circ J

110

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“…However, It is unknown if TTC segments with WMA mimic viable AMI segments at the strain level. This is important because some authors have suggested that TTC would be an aborted AMI with spontaneous reperfusion [13][14][15]. Therefore, our objective is to describe LV mechanics by 2D-strain in TTC using the longitudinal strain, emphasizing about the strain patterns, and to compare it with AMI, at the acute phase and at follow-up.…”

Section: Introductionmentioning

confidence: 99%

Relationship between acute strain pattern and recovery in tako-tsubo cardiomyopathy and acute anterior myocardial infarction: a comparative study using two-dimensional longitudinal strain

Meimoun

Abouth

Boulanger

et al. 2014

Int J Cardiovasc Imaging

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After acute-anterior myocardial infarction (AMI), left ventricular (LV) viable myocardial segments show some degree of active deformation (longitudinal shortening) despite wall motion abnormalities (WMA). Tako-tsubo cardiomyopathy (TTC) is characterized by myocardial stunning; however, it is unclear whether in TTC the strain pattern mimics AMI. To compare the strain-pattern in TTC and AMI using the 2D-longitudinal strain by speckle-tracking in segments with WMA, and its relationship with recovery of function at follow-up. 21 consecutive patients with typical TTC and 21 age-matched AMI patients treated by primary angioplasty had an analysis of LV-longitudinal strain at the acute-phase and at follow-up (1 and 6 months later for TTC and AMI respectively). The recovery of a segment was defined as normal wall motion at follow-up. Among the 706 analyzable LV-segments at the acute-phase, 406 had WMA (TTC 229, AMI 177). At follow-up, total recovery was observed for 45 % segments in AMI and 100 % in TTC, (p < 0.01). At the acute phase, systolic lengthening duration (47 ± 43 vs. 18 ± 33 %) and amplitude (0.25 ± 0.29 vs. 0.09 ± 0.19) and post systolic shortening (67 ± 53 vs. 39 ± 38 %) were higher in TTC, when compared to AMI-recovery (all, p < 0.01). In AMI, systolic lengthening duration was an independent predictor of poor recovery in multivariate analysis, linked to segmental longitudinal strain at follow-up (all, p ≤ 0.01). Furthermore, among the 57 % of segments exhibiting any systolic lengthening duration in AMI, only ¼ recovered, versus 62 % of such segments in TTC with 100 % recovery (p < 0.001). The systolic passive motion which is closely and inversely linked to recovery in AMI is paradoxically frequent and severe in TTC. This suggests that myocardial stunning in TTC and AMI is different according to longitudinal strain.

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“…The cause of Takotsubo cardiomyopathy is not fully understood, but several mechanisms have been proposed as: a) Wraparound LAD [6,7] b) Transient vasospasm [8][9][10] c) Microvascular dysfunction and d) Mid-ventricular obstruction, apical stunning [11].…”

Section: Discussionmentioning

confidence: 99%