Heart failure & cardiomyopathies
Myocardial oedema contributes to interstitial expansion and associates with mechanical and electrocardiographic changes in takotsubo syndrome: a cardiac magnetic resonance (CMR) T1 and T2 mapping study
Authors' conclusion
CMR T1 and T2 mapping demonstrated increased myocardial water content conditioning interstitial expansion in acute TTS, detected even outside areas of abnormal wall motion. Oedema burden and distribution associated with mechanical and electrocardiographic changes
Study context
- Population
- Hospitalized patients with acute takotsubo syndrome (mean age 72 ± 12 years, 94% women)
- Participants
- 32 vs 23
- Exposure
- TTS vs controls
- TTSn = 32
- Controlsn = 23reference
- Outcome
- Relationships between myocardial oedema (CMR tissue mapping), mechanical and electrical abnormalities
Methodological detailscase-control comparison, CMR T1 and T2 mapping with feature tracking and concomitant 12-lead electrocardiogram (ECG)
- Case-control comparison
- CMR T1 and T2 mapping with feature tracking and concomitant 12-lead ECG
Main finding
As reported in the abstract
Septal native T1, TTS vs controls
| Group | Value | Septal T2 | Extracellular volume (ECV) | Apicobasal T2 gradient |
|---|---|---|---|---|
| Controls | mean 970 (SD 23) msec | 46 ± 2 msec | 24 ± 1% | 2 ± 6 msec |
Controls
Valuemean 970 (SD 23) msec
Septal T246 ± 2 msec
Extracellular volume (ECV)24 ± 1%
Apicobasal T2 gradient2 ± 6 msec
- Septal native T1, T2 and ECV higher in TTS vs controls
- P < 0.001
- Apicobasal T2 gradient higher in TTS vs controls
- P < 0.001
Observational data: associations, not effects.
Further findings
Mean, %
| Outcome | TTS | Controls | P value |
|---|---|---|---|
| Basal LV wall tissue mapping and circumferential strainBasal circumferential strain | −23 (SD 3) | −24 (SD 4) | P = 0.351 |
- Basal left ventricular (LV) wall tissue mapping and circumferential strain — Basal LV wall: higher native T1, T2 and ECV in TTS
- all P < 0.002
LV mass and systolic function
- TTS had higher LV mass and worse systolic function than controls
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Myocardial oedema contributes to interstitial expansion and associates with mechanical and electrocardiographic changes in takotsubo syndrome: a CMR T1 and T2 mapping study. Eur Heart J Cardiovasc Imaging. Published 2 March 2023. doi:10.
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