Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato s.s. 554 Monserrato, Cagliari 09045, Italy.
Clinical and Experimental Radiology Unit, Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58-60 20132, Milan, Italy.
Eur J Radiol. 2024 Aug;177:111576. doi: 10.1016/j.ejrad.2024.111576. Epub 2024 Jun 15.
Takotsubo syndrome (TS) is characterized by transient myocardial dysfunction with outcomes ranging from favorable to life-threatening. Cardiovascular magnetic resonance (CMR) has emerged as an essential tool in its diagnosis and management and is consistently recommended by current guidelines in the diagnostic work-up. However, the prognostic value of CMR in patients with TS remains undetermined. The aim of this study was to assess the prognostic value of CMR in managing patients with TS.
PubMed, MEDLINE via Ovid, Scopus, and the Cochrane Library were searched to identify studies reporting the prognostic role of multiparameteric CMR in patients with TS with a follow-up ≥ 12 months. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE), defined as all-cause mortality, cardiac death, heart failure, sudden cardiac death, recurrence of TS, and cerebrovascular events.
Five studies with 564 patients were included for reporting correlation of CMR parameters with MACCE. Primary endpoint occurred in 69 (12%) patients. Among the CMR parameters assessed, myocardial strain parameters (including measurements of the left atrium, left and right ventricle), right ventricle involvement, and a CMR-based radiomics model demonstrated correlations with MACCE. Additionally, one study showed the predictive ability of a CMR score.
The current systematic review suggests that CMR may offer prognostic insights in TS patients, underscoring its potential clinical utility for integration into clinical practice. However, scarce data are currently available; hence, further research is needed.
Takotsubo 综合征（TS）的特征是短暂性心肌功能障碍，其结局从有利到危及生命不等。心血管磁共振（CMR）已成为其诊断和管理的重要工具，并且在当前的诊断工作指南中一直被推荐。然而，CMR 在 TS 患者中的预后价值仍未确定。本研究旨在评估 CMR 在管理 TS 患者中的预后价值。
通过 PubMed、Ovid 中的 MEDLINE、Scopus 和 Cochrane 图书馆检索了报告多参数 CMR 在随访时间≥12 个月的 TS 患者中的预后作用的研究。主要终点是主要不良心血管和脑血管事件（MACCE），定义为全因死亡率、心脏性死亡、心力衰竭、心源性猝死、TS 复发和脑血管事件。
纳入了 5 项研究，共 564 例患者，用于报告 CMR 参数与 MACCE 的相关性。主要终点发生在 69 例（12%）患者中。在所评估的 CMR 参数中，心肌应变参数（包括左心房、左心室和右心室的测量）、右心室受累以及基于 CMR 的放射组学模型与 MACCE 相关。此外，一项研究显示了 CMR 评分的预测能力。
目前的系统评价表明，CMR 可能为 TS 患者提供预后信息，强调其在临床实践中整合的潜在临床应用价值。然而，目前可用的数据很少，因此需要进一步研究。
