Ventricular rupture in Takotsubo cardiomyopathy

Jaguszewski, Miłosz; Fijałkowski, Marcin; Nowak, Radosław; Czapiewski, Piotr; Ghadri, Jelena-Rima; Templin, Christian; Rynkiewicz, Andrzej

doi:10.1093/eurheartj/ehs054

Cited by 36 publications

(18 citation statements)

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“…72 LV free wall rupture and ventricular septal defect are known complications leading to TTC-related death. [73][74][75][76] Post-Hospital Survival Assessments regarding long-term post-TTC survival are limited and unavoidably influenced by the older age of this patient population. Our experience supports higher all-cause mortality for TTC compared with the age-and sex-matched general population.…”

Section: Outcomementioning

confidence: 99%

Epidemiology and Clinical Profile of Takotsubo Cardiomyopathy

Sharkey

Maron

2014

Circ J

109

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Section: Outcomementioning

confidence: 99%

Epidemiology and Clinical Profile of Takotsubo Cardiomyopathy

Sharkey

Maron

2014

Circ J

109

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“…However, a local increase of wall stress due to the ballooning frequently observed in TTC could favor passive longitudinal lengthening instead of shortening for severely stunned segments. An excessive local wall stress inducing passive motion of the LV wall could weaken it in certain circumstances, maybe explaining the intriguing observation of myocardial rupture described in few cases report involving patients with typical TTC [27].…”

Section: D-strain Behavior In Ttcmentioning

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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“…Focal late gadolinium enhancement in cardiac magnetic resonance, which is believed to be evidence of irreversible fibrosis, is observed in 9-40% of patients with TTC [24][25][26][27]. Cardiac rupture is the most severe and oftentimes fatal complication of TTC, which supports the transmyocardial damage [28,29]. Histopathological findings at the rupture site include myocardial necrosis with hemorrhaging, fused foci of coagulation necrosis and contraction band necrosis, as well as diffuse patchy infarction of myocardial in the surrounding tear area [30][31][32][33].…”

mentioning

confidence: 94%