Heart failure & cardiomyopathies
Global Microvascular Dysfunction and Incomplete Recovery in Takotsubo Syndrome: Insights From Serial PET Imaging
Authors' conclusion
Patients who underwent serial positron emission tomography perfusion imaging for TTS demonstrated reversible reductions in rest and stress MBF, myocardial flow reserve, and increases in CVR, suggestive of TTS-related coronary microvascular dysfunction and subsequent subtotal recovery. Coronary microvascular dysfunction extended beyond regions of wall motion abnormalities, and regional coronary flow abnormalities persisted in the medium term even after recovery of left ventricular function.
Study context
- Population
- Patients with Takotsubo syndrome (TTS) undergoing serial cardiac PET, May 2017-June 2023130 screened
- Participants
- 62 patients
- Exposure
- Baseline vs 6-month follow-up PET
- Outcome
- Change in PET parameters: rest and stress MBF, myocardial flow reserve, CVR, perfusion abnormality extent, LV function
- Follow-up
- 6-month follow-up
Methodological detailsserial PET imaging
- Serial PET imaging
Main finding
As reported in the abstract
Global rest myocardial blood flow (MBF) improved (mL/min per gram)
0.81-0.89
P=0.004
Global stress MBF improved (mL/min per gram)
1.56-2.61
P<0.001
Myocardial flow reserve improved
1.96-2.65
P<0.001
Coronary vascular resistance (CVR) improved (mm Hg·min·g/mL)
52.0-36.2
P<0.001
Observational data: associations, not effects.
Further findings
Segmental analysis, apical TTS (subgroup)
- Improvements in stress MBF, myocardial flow reserve and CVR in all segments, including basal
- all P<0.001
- Persistent MBF and CVR abnormalities in distal segment and apex despite full LV function recovery
- n = 53 apical TTS
Original publication
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