Right Ventricular Involvement and Recovery After Acute Stress-Induced (Tako-tsubo) Cardiomyopathy

The American Journal of Cardiology
Caroline ScallyDana K Dawson

Abstract

Acute stress-induced (Tako-tsubo) cardiomyopathy is an increasingly recognized but insufficiently characterized syndrome. Here, we investigate the pathophysiology of right ventricular (RV) involvement in Tako-tsubo and its recovery time course. We prospectively recruited 31 patients with Tako-tsubo with predominantly ST-elevation electrocardiogram and 18 controls of similar gender, age, and co-morbidity distribution. Patients underwent echocardiography and cardiac magnetic resonance (CMR) imaging on a 3T Philips scanner in the acute phase (day 0 to 3 after presentation) and at 4-months follow-up. Visually, echocardiography was able to identify only 52% of patients who showed RV wall motion abnormalities on CMR. Only CMR-derived RV ejection fraction (p = 0.01) and echocardiography-estimated pulmonary artery pressure (p = 0.01) identify RV functional involvement in the acute phase. Although RV ejection fraction normalizes in most patients by 4 months, acutely there is RV myocardial edema in both functioning and malfunctioning segments, as measured by prolonged native T1 mapping (p = 0.02 for both vs controls), and this persists at 4 months in the acutely malfunctioning segments (p = 0.002 vs controls). The extracellular volume fr...Continue Reading

References

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Citations

Aug 22, 2017·Heart·Dana K Dawson
Jan 10, 2019·JACC. Basic to Translational Science·Heather M WilsonDana K Dawson
Apr 30, 2017·Nitric Oxide : Biology and Chemistry·Zhihong ZhangYuming Wu
Mar 18, 2021·Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace·Kenan YaltaTulin Yalta
Jul 14, 2020·Medicina clínica·Álvaro Aparisi, Aitor Uribarri
Apr 12, 2020·Trends in Cardiovascular Medicine·Andra Maria Ciutac, Dana Dawson
May 28, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Kihei Yoneyama, Yoshihiro J Akashi
Jun 21, 2021·Current Heart Failure Reports·Philipp-Johannes JenschIngo Eitel

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