Manganese-Enhanced Magnetic Resonance Imaging in Takotsubo Syndrome
| Autor: | Trisha Singh, Shruti Joshi, Lucy E. Kershaw, Andy H. Baker, Gerry P. McCann, Dana K. Dawson, Marc R. Dweck, Scott I. Semple, David E. Newby |
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| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Singh, T, Joshi, S, Kershaw, L E, Baker, A H, Mccann, G P, Dawson, D K, Dweck, M R, Semple, S I & Newby, D E 2022, ' Manganese-Enhanced Magnetic Resonance Imaging in Takotsubo Syndrome ', Circulation, vol. 146, no. 24, pp. 1823-1835 . https://doi.org/10.1161/CIRCULATIONAHA.122.060375 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | Background: Takotsubo syndrome is an acute cardiac emergency characterized by transient left ventricular systolic dysfunction typically following a stressful event. Despite its rapidly rising incidence, its pathophysiology remains poorly understood. Takotsubo syndrome may pass unrecognized, especially if timely diagnostic imaging is not performed. Defective myocardial calcium homeostasis is a central cause of contractile dysfunction and has not been explored in takotsubo syndrome. We aimed to investigate myocardial calcium handling using manganese-enhanced magnetic resonance imaging during the acute and recovery phases of takotsubo syndrome. Methods: Twenty patients with takotsubo syndrome (63±12 years of age; 90% female) and 20 volunteers matched on age, sex, and cardiovascular risk factors (59±11 years of age; 70% female) were recruited from the Edinburgh Heart Centre between March 2020 and October 2021. Patients underwent gadolinium and manganese-enhanced magnetic resonance imaging during index hospitalization with repeat manganese-enhanced magnetic resonance imaging performed after at least 3 months. Results: Compared with matched control volunteers, patients had a reduced left ventricular ejection fraction (51±11 versus 67±8%; P 2 ; P P P P P Conclusions: In patients with takotsubo syndrome, there is a profound perturbation of myocardial manganese uptake, which is most marked in the acute phase but persists for at least 3 months despite apparent restoration of normal left ventricular ejection fraction and resolution of myocardial edema, suggesting abnormal myocardial calcium handling may be implicated in the pathophysiology of takotsubo syndrome. Manganese-enhanced magnetic resonance imaging has major potential to assist in the diagnosis, characterization, and risk stratification of patients with takotsubo syndrome. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04623788. |
| Databáze: | OpenAIRE |
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