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Archives of cardiovascular diseases
Volume 106, n° 4
page 265 (avril 2013)
Doi : 10.1016/j.acvd.2013.03.053

Assessment of left ventricular recovery in Tako-Tsubo cardiomyopathy using 2D strain echocardiography

N. Mansencal, M. Ihaddaden, J. Delobelle, M. Arslan, R. El Mahmoud, R. Pilliere, O. Dubourg
 Hôpital Ambroise-Paré, AP–HP, Boulogne, France 

Background .– Tako-Tsubo cardiomyopathy (TTC) is characterized by transient stress induced transient left ventricular (LV) dysfunction. This LV systolic dysfunction is characterized by a recovery. The aim of this study was to assess LV involvement in TTC by 2D speckle tracking echocardiography.

Patients .– We prospectively studied 40 patients (pts) presenting with typical pattern of TTC. All patients underwent three echocardiographic examinations: at admission, at day 5 and at one-month follow-up. The diagnosis of TTC was defined according to Mayo Clinic criteria. We used the automated function imaging (AFI) in apical 2-, 3- and 4-chamber views, allowing to calculate longitudinal global strain, strain of each left ventricular segment and the bull's-eye display. This AFI method non-invasively tracks and analyzes peak systolic strain based on 2D strain.

Results .– Mean age was 70±10 y.o. (95% of women). Longitudinal global strain (LGS) was significantly depressed at admission as compared to LGS calculated at day 5 and at one-month follow-up (−6±2% versus −10±4% at day 5 versus −20±3% at one-month follow-up, P <0.0001). At admission, strain was particularly depressed in median and apical left ventricular segments and this dysfunction was circular (−2±1% versus −10±2% in basal segments). At day 5, partial recovery was observed, particularly in middle lateral and inferior walls, with an asymmetrical dysfunction. At 1-month follow-up, a complete recovery of LGS was observed in all left ventricular walls (−20±3%).

Conclusion .– Our study suggests that left ventricular systolic dysfunction is circular and may be assessed by 2D strain. Recovery is asymmetrical and is complete at 1-month follow-up.

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