Kokyu to Junkan Volume 55, Issue 12 (December 2007)

Delayed-contrast Gd-DTPA Enhanced Cardiac Magnetic Resonance in Takotsubo Cardiomyopathy Yoshihisa Naruse 1 , Norihito Saito 1 , Akihiko Uehara 1 , Toru Sugiura 1 , Seigo Yamashita 1 , Kensuke Tsutsui 1 1Department of Cardiology, Seirei Mikatahara Hospital Keyword: たこつぼ型心筋障害 , 心臓MRI , takotsubo cardiomyopathy , cardiac magnetic resonance pp.1369-1374
Published Date 2007/12/15
DOI https://doi.org/10.11477/mf.1404100946
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 Takotsubo cardiomyopathy is a condition that mimics acute coronary syndrome without typical coronary angiographic stenosis. It remains unknown whether delayed enhancement(DE) was present or not and which type of DE was observed in patients of Takotsubo cardiomyopathy. We reported three cases of Takotsubo cardiomyopathy that could be evaluated with rest Tc-MIBI SPECT and cardiac magnetic resonance(CMR) in the subacute and chronic phases. All patients were women and suffered from psychological stress. In none of the cases was significant epicardial stenosis documented in any of the acute-phase coronary angiograms. Left ventriculography revealed akinesia or dyskinesia of the mid and/or apical portion of the LV chamber compared with hyper-contraction of the basal LV. Rest Tc-MIBI SPECT in the sub-acute phase showed perfusion defect at the area of wall motion impairment. Delayed Gd-DTPA enhanced CMR in the subacute phase demonstrated diffuse smoky DE in the area matched with wall motion impairment. These CMR findings in Takotsubo cardiomyopathy differ from those observed in acute coronary syndrome. Although the SPECT imaging improved considerably, DE remained in the chronic phase. The DE CMR finding is compatible with the pathological finding.

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55巻12号 (2007年12月)
電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院