European Journal of Echocardiography Advance Access originally published online on May 28, 2009
European Journal of Echocardiography 2009 10(6):760-764; doi:10.1093/ejechocard/jep062
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Global and regional myocardial function quantification by two-dimensional strain in Takotsubo cardiomyopathy
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1 I. Medical Department, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer Ufer 1-3, Mannheim 68167, Germany
2 Department of Biometrics and Statistics, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
Received 29 December 2008; accepted after revision 3 May 2009; online publish-ahead-of-print 28 May 2009.
* Corresponding author. Tel: +49 621 383 2204; fax: +49 621 383 382. E-mail address: felixheggemann{at}gmx.de
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Abstract |
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Aims: This study sought to characterize global and regional systolic function in Takotsubo cardiomyopathy (TC) using two-dimensional (2D) strain imaging.
Methods and results: Twelve consecutive patients (11 women, 1 man) underwent 2D echocardiography on admission and on early follow-up (34 ± 16 days). Two-dimensional images were analysed to measure longitudinal and radial strain and to calculate post-systolic shortening (PSS) and the post-systolic index (PSI). Mean age was 64 ± 14 years. Upon presentation ejection fraction, average longitudinal and radial strains were 42 ± 9%, –10.6 ± 5.5%, and 20.1 ± 17.3%, respectively. Values improved to 59 ± 8%, –17.6 ± 3.0%, and 50.2 ± 17.0%, respectively (all P < 0.001). PSS was present in 69% of segments upon presentation and in 53% of segments upon follow-up. PSI was –0.16 at baseline and improved to –0.06 upon follow-up (P < 0.001).
Conclusion: Patients with TC show abnormal global and regional strain patterns during the acute phase of the disease which improve over time. However, subtle abnormalities of regional LV function seem to persist into the early follow-up period as suggested by the presence of PSS in more than half of LV segments. Long-term follow-up studies are needed to clarify whether these subtle abnormalities will further improve.
Keywords: 2D strain; myocardial function; Takotsubo; cardiomyopathy; echocardiography
Both the authors contributed equally to this work.