Comparison of Left Ventricular Contractile Abnormalities in Stress-Induced Cardiomyopathy versus Obstructive Coronary

Alexandros Briasoulis1, Karolina Marinescu1, Marian Mocanu1

  • 1Division of Cardiology, Detroit Medical Center, Wayne State University, Detroit, Michigan.

Insights

Takotsubo cardiomyopathy (TC) and acute myocardial infarction (AMI) show similar impairments in left ventricular (LV) strain. Two-dimensional strain imaging can help distinguish between TC patterns.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiomyopathy Research

Background:

  • Limited data exists on left ventricular (LV) strain profiles in takotsubo cardiomyopathy (TC) compared to obstructive coronary artery disease (CAD).
  • Investigating regional and global LV longitudinal strain in TC patients is crucial.

Purpose of the Study:

  • To compare regional and global LV longitudinal strain in patients with TC versus acute cardiomyopathy (ACM) due to severe obstructive coronary artery disease.
  • To utilize two-dimensional strain imaging (2DS) for this comparison.

Main Methods:

  • Transthoracic echocardiography was performed on 34 TC patients, 24 ACM patients, and 30 healthy controls.
  • Segmental longitudinal strain was measured using EchoInsight Epsilon software.
  • Left ventricular global longitudinal strain (GLS) was calculated by averaging segmental wall strains.

Main Results:

  • Both TC and ACM groups showed significantly impaired systolic and diastolic function compared to controls.
  • LV global and segmental systolic strain were significantly attenuated in TC and ACM patients versus controls (P < 0.001).
  • LV basal segmental longitudinal strain was higher in TC patients than ACM patients (P = 0.02).
  • Global and apical segmental strain differentiated mid-ventricular from apical TC variants (P = 0.001).

Conclusions:

  • Longitudinal LV strain parameters are similarly impaired in TC and ACM patients.
  • Two-dimensional LV strain parameters can aid in differentiating between TC patterns.
Abstract

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