Mechanisms of Acute Mitral Regurgitation in Patients With Takotsubo Cardiomyopathy
| Autor: | Yoko Fukuoka, Eiji Kuwahara, Maiko Shiota, Smruti S. Nalawadi, Takahiro Shiota, Masaki Izumo, Robert J. Siegel, Suhail Dohad, Jayanta R. Das |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Cardiomyopathy Coronary Angiography Ventricular Outflow Obstruction Electrocardiography Takotsubo Cardiomyopathy medicine.artery Internal medicine Mitral valve Humans Medicine Ventricular outflow tract Radiology Nuclear Medicine and imaging Systole Aged Aged 80 and over Chi-Square Distribution Ejection fraction medicine.diagnostic_test business.industry Mitral Valve Insufficiency Middle Aged medicine.disease Logistic Models medicine.anatomical_structure Echocardiography Pulmonary artery Cardiology Female Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Circulation: Cardiovascular Imaging. 4:392-398 |
| ISSN: | 1942-0080 1941-9651 |
| DOI: | 10.1161/circimaging.110.962845 |
| Popis: | Background— Recent studies have suggested acute mitral regurgitation (MR) as a potentially serious complication of takotsubo cardiomyopathy (TTC); however, the mechanism of acute MR in TTC remains unclear. The aim of this study was to elucidate the mechanisms of acute MR in patients with TTC. Methods and Results— Echocardiography was used to assess the mitral valve and left ventricular outflow tract (LVOT) pressure gradient in 47 patients with TTC confirmed by coronary angiography and left ventriculography. Mitral valve assessment included coaptation distance, tenting area at mid systole in the long-axis view, and systolic anterior motion of the mitral valve (SAM). Of the study patients, 12 (25.5%) had significant (moderate or severe) acute MR. In patients with acute MR versus those without acute MR, we found lower ejection fraction (31.3±6.2% versus 41.5±10.6%, P =0.001) and higher systolic pulmonary artery pressure (49.3±7.4 versus 35.5±8.9 mm Hg, P 20 mm Hg (average peak LVOT pressure gradient, 81.3±35.8 mm Hg). The remaining 6 patients with acute MR revealed significantly greater mitral valve coaptation distance (10.9±1.6 versus 7.8±1.4 mm, P 2 , P P Conclusions— SAM and tethering of the mitral valve are independent mechanisms with differing pathophysiology that can lead to acute MR in patients with TTC. |
| Databáze: | OpenAIRE |
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