T2- and T1-mapping are novel CMR techniques allowing tissue characterization.

To assess myocardial involvement using T2- and T1-mapping in Tako-Tsubo cardiomyopathy (TC).

9 patients with TC and 15 controls were prospectively enrolled. Cardiovascular magnetic resonance (CMR) was performed a mean 2.8 days after the onset of symptoms and after a mean 4.6 month follow-up. CMR was applied using T2-mapping, pre and post contrast T1-mapping (MOLLI) and late gadolinium enhancement (LGE) sequences. Segmental and global T1 values have been measured before and after contrast administration.

All patients were female, had positive troponin (6±9µg/l) and medium and/or apical ballooning associated with moderate LV dysfunction (EF 44±7%). On admission, compared with controls, TC patients had significantly higher T2 values (65±6ms vs 50±4ms, p<0.0001). Myocardial T2 was significantly higher in segments with Wall motion abnormality (WMA) compared to normokinetic segments (67±12ms vs 61.5±8ms, p=0.003). Compared with controls, TC patients had significantly higher pre contrast T1 values (1115±92 versus 1016±89, p<0.0001) and significantly lower post contrast T1 values (428±24ms vs 466±19ms, p=0.02).Pre contrast T1 values were significantly higher in segments with WMA compared to normal segments (1126±95 vs 1089±85, p=0.016).

Post contrast T1 values were not significantly different in abnormal segments compared to normal segments (421±56 vs 431±50, p=0.15). No patients had LGE. At follow-up: all had a complete LV recovery (EF: 67±4%) without significant WMA. Mean T2 and pre contrast T1 values decreased significantly (53±6ms vs 65±8ms, p=0.001 and 1016±76 vs 1115±80, p=0.001 respectively). No differences were observed regarding post contrast T1 values.

In TC patients, T2-mapping and pre contrast T1-mapping allow identification of reversible myocardial injury. Post contrast T1 mapping does not provide additional information.