Echocardiographic assessment of takotsubo cardiomyopathy: beyond apical ballooning

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• 作者：Hiroyuki Okura
• 关键词：Takotsubo cardiomyopathy ; Echocardiography ; SAM ; Left ventricular outflow obstruction ; Mitral regurgitation ; Left ventricular thrombus
• 刊名：Journal of Echocardiography
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：14
• 期：1
• 页码：13-20
• 全文大小：6,704 KB
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• 作者单位：Hiroyuki Okura (1)
  
  1. First Department of Internal Medicine, Nara Medical University, 840 Shijo, Kashihara, Nara, 634-8522, Japan
  
• 刊物主题：Cardiology; Ultrasound; Imaging / Radiology;
• 出版者：Springer Japan
• ISSN：1880-344X

文摘

It has been >25 years since the first report of the takotsubo cardiomyopathy (TC). Although left ventriculography was originally used to depict its typical and impressive wall motion abnormality mimicking “takotsubo”, or octopus pot, echocardiography plays a pivotal role in detecting not only its left ventricular (LV) wall motion abnormality, apical ballooning, but also various other findings. First of all, apical ballooning is not an essential finding for TC anymore. Mid-ventricular LV asynergy with or without apical involvement is a basic pattern of the LV wall motion abnormality. Distribution and time course of the asynergy may be best detected by echocardiography and echo provides useful information to differentiate between TC and acute coronary syndrome or acute myocarditis. In addition to the wall motion assessment, echo detects complications of TC such as systolic anterior motion of the mitral leaflet with or without LV outflow obstruction, mitral regurgitation, LV thrombus, right ventricular (RV) involvement. In particular, RV involvement is not an uncommon finding and is associated with worse short-term as well as long-term prognosis. Finally, coronary flow measurements and speckle tracking by echo may offer additional and useful information about pathophysiology and prognosis of TC. In conclusion, echocardiography is a standard imaging modality for detecting various dynamic findings beyond apical ballooning in patients with TC.