Right ventricular strain assessment by cardiovascular magnetic resonance myocardial feature tracking allows optimized risk stratification in Takotsubo syndrome

PloS One
Thomas StiermaierIngo Eitel

Abstract

A substantial number of patients with Takotsubo syndrome (TTS) exhibit right ventricular (RV) dysfunction which has been associated with adverse outcome. The aim of this study was to assess the clinical and prognostic value of RV myocardial strain in TTS using cardiovascular magnetic resonance myocardial feature tracking (CMR-FT). CMR-FT was performed in a core laboratory to determine RV longitudinal strain in 134 TTS patients undergoing CMR in median 2 days after admission to 2 experienced centers. For comparison, RV involvement was evaluated by sole visual assessment concerning RV contraction abnormalities. Both approaches were analyzed regarding their long-term prognostic value. The peak global RV longitudinal strain was in median -19%. Segmental analyses located contraction abnormalities primarily in the apical parts of the right ventricle. Sole visual assessment identified 38 patients (28%) with RV involvement. These patients showed a numerically higher long-term mortality without reaching statistical significance (17.1% versus 10.5%; hazard ratio 1.38 [95% confidence interval 0.49-3.88]; p = 0.31). The optimal RV strain cutoff value for risk prediction was -17.24%. Stratification according to this threshold categorized 41...Continue Reading

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Citations

Nov 28, 2019·American Journal of Physiology. Heart and Circulatory Physiology·Emil Knut Stenersen EspeIvar Sjaastad
Apr 11, 2020·Journal of Clinical Medicine·Martin ReindlSebastian Johannes Reinstadler
May 2, 2021·Current Heart Failure Reports·Torben Lange, Andreas Schuster
Jun 21, 2021·Current Heart Failure Reports·Philipp-Johannes JenschIngo Eitel

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