Goto Hiroki, Kato Ken, Imori Yoichi, Wakita Masaki, Eguchi Noriko, Takaoka Hiroyuki, Murakami Tsutomu, Nagatomo Yuji, Isogai Toshiaki, Mitsuhashi Yuya, Saji Mike, Yamashita Satoshi, Maekawa Yuichiro, Mochizuki Hiroki, Takaoka Yoshimitsu, Ono Masafumi, Yamaguchi Tetsuo, Kobayashi Yoshio, Asai Kuniya, Shimizu Wataru, Yoshikawa Tsutomu
Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan.
Department of Cardiovascular Medicine, Nippon Medical School Hospital, Tokyo 113-8603, Japan.
J Clin Med. 2024 May 30;13(11):3238. doi: 10.3390/jcm13113238.
Although takotsubo syndrome (TTS) is characterized by transient systolic dysfunction of the left ventricle (LV), the time course and mechanism of LV function recovery remain elusive. The aim of this study is to evaluate cardiac functional recovery in TTS via serial cardiac magnetic resonance feature tracking (CMR-FT). In this Japanese multicenter registry, patients with newly diagnosed TTS were prospectively enrolled. In patients who underwent serial cardiovascular magnetic resonance (CMR) imaging at 1 month and 1 year after the onset, CMR-FT was performed to determine the global circumferential strain (GCS), global radial strain (GRS) and global longitudinal strain (GLS). We compared LV ejection fraction, GCS, GRS and GLS at 1 month and 1 year after the onset of TTS. Eighteen patients underwent CMR imaging in one month and one year after the onset in the present study. LV ejection fraction had already normalized at 1 month after the onset, with no significant difference between 1 month and 1 year (55.8 ± 9.2% vs. 58.9 ± 7.3%, = 0.09). CMR-FT demonstrated significant improvement in GCS from 1 month to 1 year (-16.7 ± 3.4% vs. -18.5 ± 3.2%, < 0.01), while there was no significant difference in GRS and GLS between 1 month and year (GRS: 59.6 ± 24.2% vs. 59.4 ± 17.3%, = 0.95, GLS: -12.8 ± 5.9% vs. -13.8 ± 4.9%, = 0.42). Serial CMR-FT analysis revealed delayed improvement of GCS compared to GRS and GLS despite of rapid recovery of LV ejection fraction. CMR-FT can detect subtle impairment of LV systolic function during the recovery process in patients with TTS.
虽然应激性心肌病（TTS）的特征是左心室（LV）的短暂收缩功能障碍，但左心室功能恢复的时间进程和机制仍不清楚。本研究的目的是通过连续心脏磁共振特征追踪（CMR-FT）评估TTS患者的心脏功能恢复情况。在这个日本多中心注册研究中，新诊断为TTS的患者被前瞻性纳入。在发病后1个月和1年接受连续心血管磁共振（CMR）成像的患者中，进行CMR-FT以确定整体圆周应变（GCS）、整体径向应变（GRS）和整体纵向应变（GLS）。我们比较了TTS发病后1个月和1年时的左心室射血分数、GCS、GRS和GLS。本研究中18例患者在发病后1个月和1年接受了CMR成像。左心室射血分数在发病后1个月已恢复正常，1个月和1年之间无显著差异（55.8±9.2%对58.9±7.3%，P = 0.09）。CMR-FT显示从1个月到1年GCS有显著改善（-16.7±3.4%对-18.5±3.2%，P < 0.01），而1个月和1年之间GRS和GLS无显著差异（GRS：59.6±24.2%对59.4±17.3%，P = 0.95，GLS：-12.8±5.9%对-13.8±4.9%，P = 0.42）。连续CMR-FT分析显示，尽管左心室射血分数迅速恢复，但与GRS和GLS相比，GCS改善延迟。CMR-FT可以检测TTS患者恢复过程中左心室收缩功能的细微损害。
