Assessment of left ventricular recovery in Tako-Tsubo cardiomyopathy using 2D strain echocardiography

N. Mansencal, M. Ihaddaden, J. Delobelle, M. Arslan, R. El Mahmoud, R. Pilliere, O. Dubourg
2013 Archives of Cardiovascular Diseases  
Background.-Tako-Tsubo cardiomyopathy (TTC) is characterized by transient stress induced transient left ventricular (LV) dysfunction. This LV systolic dysfunction is characterized by a recovery. The aim of this study was to assess LV involvement in TTC by 2D speckle tracking echocardiography. Patients.-We prospectively studied 40 patients (pts) presenting with typical pattern of TTC. All patients underwent three echocardiographic examinations: at admission, at day 5 and at one-month follow-up.
more » ... he diagnosis of TTC was defined according to Mayo Clinic criteria. We used the automated function imaging (AFI) in apical 2-, 3-and 4-chamber views, allowing to calculate longitudinal global strain, strain of each left ventricular segment and the bull's-eye display. This AFI method non-invasively tracks and analyzes peak systolic strain based on 2D strain. Results.-Mean age was 70 ± 10 y.o. (95% of women). Longitudinal global strain (LGS) was significantly depressed at admission as compared to LGS calculated at day 5 and at one-month follow-up (−6 ± 2% versus −10 ± 4% at day 5 versus −20 ± 3% at one-month follow-up, P < 0.0001). At admission, strain was particularly depressed in median and apical left ventricular segments and this dysfunction was circular (−2 ± 1% versus −10 ± 2% in basal segments). At day 5, partial recovery was observed, particularly in middle lateral and inferior walls, with an asymmetrical dysfunction. At 1-month follow-up, a complete recovery of LGS was observed in all left ventricular walls (−20 ± 3%). Conclusion.-Our study suggests that left ventricular systolic dysfunction is circular and may be assessed by 2D strain. Recovery is asymmetrical and is complete at 1-month follow-up. http://dx.
doi:10.1016/j.acvd.2013.03.053 fatcat:udkyckwtlzgcza6ujf6cjietia