Myocardial oedema contributes to interstitial expansion and associates with mechanical and electrocardiographic changes in takotsubo syndrome: a CMR T1 and T2 mapping study

• DOI: 10.1093/ehjci/jead035
• Publication Date: 2023-03-02T14:31:00Z
• Authors: Luca Arcari; Giovanni Camastra; Federica Ciolina; Luca Rosario Limite; Massimiliano Danti; Matteo Sclafani; Gerardo Ansalone; Maria Beatrice Mu...; Eike Nagel; Valentina Puntmann; Stefano Sbarbati; Luca Cacciotti
• Keywords: Basal (medicine)

Abstract Aims myocardial oedema is largely represented in takotsubo syndrome (TTS) and may contribute to alter the myocardium morphology function. The aim of study describe relationships between oedema, mechanical, electrical abnormalities TTS Methods results included n = 32 hospitalized patients 23 controls. Cardiac magnetic resonance (CMR) with tissue mapping feature tracking was performed concomitant 12-lead electrocardiogram (ECG) recording. Mean age 72 ± 12 years old, 94% women. Compared controls, had higher left ventricular (LV) mass, worse systolic function, septal native T1 (1116 73 msec vs. 970 msec, P < 0.001), T2 (56 5 46 2 extracellular volume (ECV) fraction (32 5% 24 1%, 0.001). apicobasal gradient values (12 6 0.001); basal LV wall displayed T1, T2, ECV (all 0.002) but similar circumferential strain against controls (−23 3% −24 4%, 0.351). In cohort, showed significant correlations (r 0.609, 0.689, ejection −0.459, 0.008) aVR voltage −0.478, 0.009). Negative T-wave QTc length correlated 0.499, 0.007 r 0.372, 0.047, respectively) not other measurements. Conclusions CMR demonstrated increased water content conditioning interstitial expansion acute TTS, detected even outside areas abnormal motion. Oedema burden distribution associated mechanical electrocardiographic changes, making it a potential prognostic marker therapeutic target TTS.