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Published on: June 28, 2019

Diffuse, marked, reversible impairment in coronary microcirculation in stress cardiomyopathy: a Doppler transthoracic

Fausto Rigo1, Rosa Sicari, Rodolfo Citro

  • 1Cardiology Division, Umberto I Hospital, Mestre-Venice, Italy.

Annals of Medicine
|June 4, 2009
PubMed

Insights

Coronary flow reserve (CFR) is impaired in tako-tsubo cardiomyopathy (TC) acutely but recovers rapidly. This microcirculatory disturbance parallels functional recovery in TC patients.

Area of Science:

  • Cardiology
  • Cardiovascular Physiology

Background:

  • Tako-tsubo cardiomyopathy (TC), also known as stress-induced cardiomyopathy, presents with acute left ventricular dysfunction.
  • The underlying pathophysiology, particularly concerning coronary microcirculation, remains incompletely understood.

Purpose of the Study:

  • To evaluate coronary flow reserve (CFR) in patients diagnosed with TC.
  • To assess the temporal changes in CFR during the acute and recovery phases of TC.

Main Methods:

  • Transthoracic dipyridamole stress echocardiography and pulsed Doppler CFR assessment were performed in 30 TC patients and 30 controls.
  • CFR was measured in the left anterior descending (LAD) and posterior descending (PD) arteries.
  • Wall motion score index (WMSI) and CFR were assessed at baseline, day 1, day 7, and 6 months post-admission.

Main Results:

  • Patients with TC exhibited significantly reduced CFR on admission (day 1) compared to controls.
  • A rapid and significant recovery of CFR was observed by day 7, with values stabilizing at 6 months.
  • Functional recovery, indicated by WMSI, paralleled the improvement in CFR.

Conclusions:

  • TC is associated with a significant, diffuse coronary microcirculatory disturbance during the acute phase.
  • This microcirculatory dysfunction shows early reversal, normalizing within days.
  • The findings suggest that early recovery of CFR is a key feature of TC, correlating with wall motion recovery.
Abstract

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