Abstract
Background: Late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR) has been recommended to distinguish Tako-Tsubo cardiomyopathy (TTC) from either acute myocardial infarction or myocarditis. Method: Forty-four consecutive patients with confirmed Mayo Clinic criteria for TTC underwent CMR imaging at 1.5 Tesla during the acute phase. LGE was quantitated at two signal thresholds (CircleCVi software) at >2 and >5 standard-deviations (SD)above reference myocardium, and compared to biomarkers. Findings: Mean door-to-CMR time was 57 h. Eighteen patients (41%) had LGE >2SD localised to the area of abnormal wall motion, representing 28.9 ± 11.2% LV mass. In 16 of these 18 patients (89%) LGE was >5 SD above normal myocardium, representing 12.1 ± 10% LV mass. Mean troponin was significantly higher in LGE positive patients (2.5 ± 1.8 vs 4.4 ± 6.9, p = 0.001). Mean ejection fraction (EF) by CMR was 45 ± 8.7% in LGE-negative, and 40 ± 7.1 in LGE-positive patients (p = 0.37). Recovery of segmental function was confirmed at follow-up, mean EF was 59% in both groups. Conclusion: LGE was present in 41% of cases of TTC, 89% of which had intense enhancement >5 SD above normal myocardium. Presence of LGE was associated with worse myocardial injury in the acute setting, with no difference in recovery of function.
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call