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In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
08:13

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography

Published on: February 16, 2016

Angiographic assessment of myocardial perfusion in Tako-Tsubo syndrome

Alberto R De Caterina1, Antonio Maria Leone, Leonarda Galiuto

  • 1Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.

International Journal of Cardiology
|August 17, 2013
PubMed

Insights

Myocardial perfusion is impaired in Tako-Tsubo syndrome (TTS) compared to ST-elevation myocardial infarction (STEMI) with reperfusion, but less impaired than STEMI with microvascular obstruction. This study assessed angiographic myocardial perfusion in TTS patients versus controls and STEMI patients.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Tako-Tsubo syndrome (TTS) is increasingly recognized, with coronary microvascular dysfunction proposed as its underlying mechanism.
  • Understanding the precise hemodynamic and perfusion abnormalities in TTS is crucial for diagnosis and management.

Purpose of the Study:

  • To quantitatively assess and compare myocardial perfusion using angiography in patients with TTS.
  • To differentiate TTS perfusion patterns from those observed in ST-elevation myocardial infarction (STEMI) with reperfusion (SR) and STEMI with microvascular obstruction (SMVO), as well as healthy controls (CTR).

Main Methods:

  • Retrospective analysis of 25 TTS patients, 25 CTR, 25 SR, and 25 SMVO patients.
  • Assessment of TIMI flow, TIMI frame count (TFC), and myocardial blush grade (MBG) in the left ventricular apex.
  • Quantitative myocardial perfusion evaluation using the validated open-source software 'Quantitative Blush Evaluator' (QuBE).

Main Results:

  • TTS patients exhibited significantly lower TIMI flow and higher TFC compared to CTR and SR, but not significantly different from SMVO.
  • Myocardial blush grade was significantly lower in TTS than CTR and SR, but higher than SMVO.
  • Quantitative Blush Evaluator scores were significantly lower in TTS compared to CTR and SR, and higher compared to SMVO.

Conclusions:

  • Angiographic assessment reveals impaired myocardial perfusion in TTS patients.
  • Myocardial perfusion is more compromised in TTS than in STEMI with reperfusion.
  • Myocardial perfusion deficits in TTS are less severe than in STEMI with microvascular obstruction.
Abstract

Keywords:
Microvascular dysfunctionMyocardial blush gradeQuBETako-Tsubo syndrome

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