Heggemann Felix, Weiss Christel, Hamm Karsten, Kaden Jens, Süselbeck Tim, Papavassiliu Theano, Borggrefe Martin, Haghi Dariusch
I. Medical Department, University Medical Center Mannheim, University of Heidelberg, Mannheim 68167, Germany.
Eur J Echocardiogr. 2009 Aug;10(6):760-4. doi: 10.1093/ejechocard/jep062. Epub 2009 May 28.
This study sought to characterize global and regional systolic function in Takotsubo cardiomyopathy (TC) using two-dimensional (2D) strain imaging.
Twelve consecutive patients (11 women, 1 man) underwent 2D echocardiography on admission and on early follow-up (34 +/- 16 days). Two-dimensional images were analysed to measure longitudinal and radial strain and to calculate post-systolic shortening (PSS) and the post-systolic index (PSI). Mean age was 64 +/- 14 years. Upon presentation ejection fraction, average longitudinal and radial strains were 42 +/- 9%, -10.6 +/- 5.5%, and 20.1 +/- 17.3%, respectively. Values improved to 59 +/- 8%, -17.6 +/- 3.0%, and 50.2 +/- 17.0%, respectively (all P < 0.001). PSS was present in 69% of segments upon presentation and in 53% of segments upon follow-up. PSI was -0.16 at baseline and improved to -0.06 upon follow-up (P < 0.001).
Patients with TC show abnormal global and regional strain patterns during the acute phase of the disease which improve over time. However, subtle abnormalities of regional LV function seem to persist into the early follow-up period as suggested by the presence of PSS in more than half of LV segments. Long-term follow-up studies are needed to clarify whether these subtle abnormalities will further improve.
本研究旨在使用二维(2D)应变成像来描述应激性心肌病(TC)的整体和局部收缩功能。
连续12例患者(11名女性,1名男性)在入院时及早期随访(34±16天)时接受了二维超声心动图检查。分析二维图像以测量纵向和径向应变,并计算收缩后缩短(PSS)和收缩后指数(PSI)。平均年龄为64±14岁。就诊时射血分数、平均纵向和径向应变分别为42±9%、-10.6±5.5%和20.1±17.3%。这些值分别改善至59±8%、-17.6±3.0%和50.2±17.0%(均P<0.001)。就诊时69%的节段存在PSS,随访时为53%。基线时PSI为-0.16,随访时改善至-0.06(P<0.001)。
TC患者在疾病急性期表现出整体和局部应变模式异常,且随时间改善。然而,超过半数左心室节段存在PSS提示,左心室局部功能的细微异常在早期随访期似乎持续存在。需要长期随访研究来阐明这些细微异常是否会进一步改善。