Abstract 2573: Usefulness of 2D Speckle Tracking Echocardiography for Assessment of Tako-Tsubo Syndrome

Abstract

Background: The pathogenesis of Tako-Tsubo (TT) syndrome (stress-induced cardiomyopathy) is not yet understood. Velocity vector imaging (VVI) is a new echocardiographic technology that measures myocardial velocity and deformation using 2D speckle tracking. The aim of this study was to compare the pattern of VVI in pts with TT sy, coronary artery disease (CAD) and in healthy pts. Methods: We prospectively studied 36 consecutive pts divided in 3 groups: 12 pts with confirmed TT sy (group 1), 12 pts with CAD defined as a documented LAD occlusion (group 2) and 12 healthy pts (group 3) and all groups were age- and sex-matched. We systematically performed echocardiography in all pts, with the use of VVI technology, allowing to measure peak velocity (V), strain (S) and strain rate (SR) in basal, mid and apical septum and free wall (FW) in apical 4-chamber view. Results: Mean age was 76 ± 8 yo in each group (36 women). Mean values of V, S and SR in mid and apical septum and FW were significantly lower in TT sy (p<0.04), as compared to group3, but not with group2. In group 1 as well as in control group, no significant differences for the values of V, S and SR were observed between basal septum and bas.FW, between mid septum and midFW and between apical septum and ap.FW (p=NS, Fig ), whereas in patients with CAD (group 2), basal septal V was significantly higher versus basal FW V (p=0.04) and apical septal V was significantly lower versus apical FW V (p=0.02). Conclusion: Our study suggests that VVI allows to distinguish patients with TT sy from those with CAD. In TT sy, left ventricular dysfunction is circular, whereas pts with LAD occlusion presented segmental wall motion abnormalities detected by VVI.