| 1. |
- Loiske, Karin, 1978-, et al.
(author)
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Left and right ventricular systolic long-axis function and diastolic function in patients with takotsubo cardiomyopathy
- 2011
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In: Clinical Physiology and Functional Imaging. - Oxford : Wiley. - 1475-0961 .- 1475-097X. ; 31:3, s. 203-208
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Journal article (peer-reviewed)abstract
- Aims: Takotsubo cardiomyopathy is characterized by apical wall motion abnormalities without coronary stenosis. Limited information is available on the genesis of the underlying reversible contractile disorder. Our objective in this prospective study was to investigate biventricular changes in systolic long-axis function and diastolic parameters in the acute phase and after recovery.Methods and results: Thirteen consecutive patients were examined by echocardiography and coronary angiography at admission and again by echocardiography after 3 months. Amplitudes, systolic and diastolic velocities of the mitral and tricuspid annuli and conventional diastolic parameters were measured. Systolic long-axis shortening of the left ventricle (LV) and right ventricle (RV) improved from 9·6 ± 2·2 mm to 11·2 ± 1·9 mm (P = 0·02) and from 21·3 ± 3·6 mm to 24·1 ± 2·8 mm (P = 0·02), respectively. LV systolic, early and late diastolic velocities measured by pulsed-wave tissue Doppler also improved, while additional conventional diastolic parameters of the LV and RV diastolic function were unchanged.Conclusions: Takotsubo cardiomyopathy temporarily affects systolic LV and RV function, while most diastolic parameters remain unchanged
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| 2. |
- Waldenborg, Micael, 1981-, et al.
(author)
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Multidisciplinary assessment of takotsubo cardiomyopathy : a prospective case study
- 2011
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In: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261 .- 1471-2261. ; 11, s. 14-
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Journal article (peer-reviewed)abstract
- Background: The cause of tako tsubo cardiomyopathy remains unclear. We used a multidisciplinary approach to investigate if a common pathophysiological denominator could be outlined.Methods: Within 3 days following symptom presentation and again after 3 months we investigated all patients coming to our institution and diagnosed with tako-tsubo cardiomyopathy. Patients underwent extensive biochemical screening. Left ventricular function was evaluated by echocardiography and contrast-enhanced cardiac magnetic resonance imaging. Cardiac autonomic function was studied by heart rate variability and signal-averaged electrocardiogram and posttraumatic stress and depression were investigated by questionnaires (the Posttraumatic Stress Syndrome 10-Questions Inventory, PTSS-10 and the Montgomery-Asberg depression rating scale, self rated version, MADRS-S).Results: During 2 years, 13 consecutive patients were included. Markers of myocardial damage and heart failure were slightly to moderately elevated and ejection fraction (echocardiography and MRi) was moderately reduced at hospitalization and improved to normal values in all patients. Signal averaged ECG demonstrated a statistically significant shorter duration of the filtered QRS complex in the acute phase as compared to follow-up. In heart rate variability analysis, SDNN and SDANN were shorter acutely compared to follow-up. Two patients fulfilled criteria for posttraumatic stress syndrome while 7 patients were in the borderline zone. There was a statistically significant inverse correlation between PTSS-10 score and QRS duration in the signal-averaged ECG (r = -0.66, P = 0.01).Conclusions: Patients with tako tsubo cardiomyopathy have altered cardiac autonomic function and a high incidence rate of borderline or definite posttraumatic stress syndrome acutely. This is in line with findings in patients with myocardial infarction and does not allow conclusions on cause and effect.
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