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The clinical impact of late gadolinium enhancement in Takotsubo cardiomyopathy: serial analysis of cardiovascular magnetic resonance images.

AbstractBACKGROUND:
Our study aimed to investigate both the clinical implications of late gadolinium enhancement (LGE) by cardiovascular magnetic resonance (CMR) and the relation of LGE to clinical findings in patients with Takotsubo cardiomyopathy (TTC).
METHODS:
We evaluated 20 consecutive patients (2 men, 18 women; median age, 77 years; interquartile range [IQR] 67-82 years) who were admitted to our hospital with the diagnosis of TTC. CMR was performed within 1 week after admission, and follow-up studies were conducted 1.5 and 6 months later.
RESULTS:
In 8 patients, CMR imaging during the sub-acute phase revealed LGE in the area matched with wall motion impairment. Cardiogenic shock was more frequently observed in patients with LGE than in those without LGE (38% vs 0%, p = 0.049). The patients with LGE needed a longer duration for ECG normalization and recovery of wall motion than did those without LGE (median 205 days, IQR [152-363] vs 68 days, [43-145], p = 0.005; 15 days, [10-185] vs 7 days, [4-13], p = 0.030, respectively). In 5 of these 8 patients, LGE disappeared within 45-180 days (170, IQR [56-180]) of onset. The patients with LGE remaining in the chronic phase had higher peak creatine kinase levels than did those without LGE (median 307 IU/L, IQR [264-460] vs 202 IU/L, [120-218], p = 0.017).
CONCLUSION:
LGE by CMR in the sub-acute phase may be associated with the severity and prolonged recovery to normal of clinical findings in TTC.
AuthorsYoshihisa Naruse, Akira Sato, Kazuyuki Kasahara, Kiwa Makino, Makoto Sano, Yasuyo Takeuchi, Shiro Nagasaka, Yasushi Wakabayashi, Hideki Katoh, Hiroshi Satoh, Hideharu Hayashi, Kazutaka Aonuma
JournalJournal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance (J Cardiovasc Magn Reson) Vol. 13 Pg. 67 (Oct 29 2011) ISSN: 1532-429X [Electronic] England
PMID22035445 (Publication Type: Journal Article)
Chemical References
  • Contrast Media
  • Gadolinium DTPA
Topics
  • Aged
  • Aged, 80 and over
  • Contrast Media
  • Coronary Angiography
  • Electrocardiography
  • Female
  • Gadolinium DTPA
  • Heart Conduction System (physiopathology)
  • Humans
  • Japan
  • Magnetic Resonance Imaging, Cine
  • Male
  • Middle Aged
  • Myocardial Contraction
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Recovery of Function
  • Severity of Illness Index
  • Stroke Volume
  • Takotsubo Cardiomyopathy (diagnosis, physiopathology)
  • Time Factors
  • Ventricular Function, Left

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