Advanced cardiac magnetic resonance imaging in takotsubo cardiomyopathy

Ojha, Vineeta; Khurana, Rishabh; Ganga, Kartik P.; Kumar, Sanjeev

doi:10.1259/bjr.20200514

Cited by 21 publications

(12 citation statements)

References 32 publications

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“…Although the pathophysiology of myocardial inflammation in stress CM is not well-known, increased myocardial edema on imaging may indicate a direct inflammatory process from the syndrome, a secondary effect stemming from elevated sympathetic drive, or microvascular ischemia associated with stress CM (41,48,49).…”

Section: Myocardial Edemamentioning

confidence: 99%

Cardiovascular Imaging in Stress Cardiomyopathy (Takotsubo Syndrome)

Zghyer

Botheju

Kiss

et al. 2022

Front. Cardiovasc. Med.

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Stress cardiomyopathy (Takotsubo syndrome) is a reversible syndrome stemming from myocardial injury leading to systolic dysfunction and is usually noted in the setting of a stressful event, be it an emotional or physical trigger. While the exact pathophysiology behind stress cardiomyopathy is yet unknown, there is ample evidence suggesting that neurocardiogenic mechanisms may play an important role. Although historically stress cardiomyopathy was generally thought to be a relatively benign condition, there is growing recognition of the cardiovascular complications associated with it despite its reversibility. Our review aims to shed light onto key cardiovascular imaging modalities used to diagnose stress cardiomyopathy while highlighting the role that imaging plays in assessing disease severity, identifying complications, dictating treatment approaches, and in short-term and long-term prognosis.

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Section: Myocardial Edemamentioning

confidence: 99%

Cardiovascular Imaging in Stress Cardiomyopathy (Takotsubo Syndrome)

Zghyer

Botheju

Kiss

et al. 2022

Front. Cardiovasc. Med.

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“…It has been hypothesised that the elevated catecholamines observed in TTS have a role in the microvascular dysfunction noted in patients with TTS, correlating with improvement in myocardial function[ 58 ]. While not established in TTS, there is emerging evidence in the utility of quantitative perfusion CMRI to more objectively assess the role that microvascular dysfunction plays in this syndrome, and is subject to further research[ 59 ].…”

Section: Ttsmentioning

confidence: 99%

Role of cardiac magnetic resonance imaging in troponinemia syndromes

Nguyen¹,

Assad²,

Femia³

et al. 2022

WJC

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Cardiac magnetic resonance imaging (MRI) is an evolving technology, proving to be a highly accurate tool for quantitative assessment. Most recently, it has been increasingly used in the diagnostic and prognostic evaluation of conditions involving an elevation in troponin or troponinemia. Although an elevation in troponin is a nonspecific marker of myocardial tissue damage, it is a frequently ordered investigation leaving many patients without a specific diagnosis. Fortunately, the advent of newer cardiac MRI protocols can provide additional information. In this review, we discuss several conditions associated with an elevation in troponin such as myocardial infarction, myocarditis, Takotsubo cardiomyopathy, coronavirus disease 2019 related cardiac dysfunction and athlete’s heart syndrome.

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“…Management of patients who have been discharged after an episode of TTS aims at systematic attention at follow-up with an eye for monitoring for CAD risk factors, cardiovascular and other comorbidities, and recurrence of TTS ( Section 6 ). Early on, follow-up should evaluate whether the LVWMAs have dissipated and the LVEF has returned to normal, or to a pre-TTS status level; this can be accomplished by a repeat ECHO, or a firstly performed cardiac magnetic resonance imaging (cMRI), which in addition to the assessment of LV function can provide insights about the resolution of LV thrombus, persistence of myocardial edema (ME), and presence of myocardial fibrosis and/or scarring [ 102 ]. The outcome of atrial arrhythmias and VA, which emerged during hospitalization, or appeared after discharge, and the associated QTc prolongation in the ECG, should be of utmost concern to the physicians.…”

Section: Current Follow-up Management Of Patients With Ttsmentioning

confidence: 99%

Takotsubo Cardiomyopathy: Current Treatment

Madias

2021

JCM

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Management of takotsubo syndrome (TTS) is currently empirical and supportive, via extrapolation of therapeutic principles worked out for other cardiovascular pathologies. Although it has been emphasized that such non-specific therapies for TTS are consequent to its still elusive pathophysiology, one wonders whether it does not necessarily follow that the absence of knowledge of TTS’ pathophysiological underpinnings should prevent us for searching, designing, or even finding, therapies efficacious for its management. Additionally, it is conceivable that therapy for TTS may be in response to pathophysiological/pathoanatomic/pathohistological consequences (e.g., “myocardial stunning/reperfusion injury”), common to both TTS and coronary artery disease, or other cardiovascular disorders). The present review outlines the whole range of management principles of TTS during its acute phase and at follow-up, including considerations pertaining to the recurrence of TTS, and commences with the idea that occasionally management of TTS should consist of mere observation along the “first do no harm” principle, while self-healing is under way. Finally, some new therapeutic hypotheses (i.e., large doses of insulin infusions in association with the employment of intravenous short- and ultrashort-acting β-blockers) are being entertained, based on previous extensive animal work and limited application in patients with neurogenic cardiomyopathy and TTS.

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Advanced cardiac magnetic resonance imaging in takotsubo cardiomyopathy

Cited by 21 publications

References 32 publications

Cardiovascular Imaging in Stress Cardiomyopathy (Takotsubo Syndrome)

Cardiovascular Imaging in Stress Cardiomyopathy (Takotsubo Syndrome)

Role of cardiac magnetic resonance imaging in troponinemia syndromes

Takotsubo Cardiomyopathy: Current Treatment

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