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Left ventricular mechanics in the acute phase of Takotsubo cardiomyopathy: distinctive ballooning patterns translate into different diastolic properties.
- Source :
-
Heart and vessels [Heart Vessels] 2020 Apr; Vol. 35 (4), pp. 537-543. Date of Electronic Publication: 2019 Sep 27. - Publication Year :
- 2020
-
Abstract
- Although apical and midventricular Takotsubo cardiomyopathies (TTCs) share common triggers and pathophysiological features, little is known about the potential differences in left ventricular (LV) mechanistic properties between these TTC phenotypes. We sought to investigate whether LV systolic and/or diastolic function, as assessed invasively by left heart catheterization (LHC), differ according to ballooning patterns in the acute phase of TTC. One hundred and fourteen TTC patients were retrospectively identified between January 2009 and December 2015 at the University Hospital of Strasbourg, France. A comprehensive list of LV quantitative parameters was derived from LHC analysis for each patient. We examined 2 groups of patients according to ballooning patterns in the acute phase of TTC: patients with apical ballooning ("Apical group"; n = 76) and those with midventricular ballooning ("Midventricular group"; n = 38). LV minimal diastolic pressure (8.72 ± 6.72 vs. 5.02 ± 6.08 mmHg; p = 0.004), LV end diastolic pressure (23.11 ± 8.32 vs. 18.84 ± 8.06 mmHg; p = 0.01), and LV diastolic stiffness (LV stiffness 1: 0.29 ± 0.23 vs. 18.84 ± 8.06 mmHg/mL; p = 0.04-LV stiffness 2: 0.16 ± 0.08 vs. 0.12 ± 0.05 mmHg/mL; p = 0.005) were significantly higher in patients with apical TTC than in the midventricular group. Concomitantly, these findings were associated with significantly higher BNP levels in the apical group (923.91 ± 1164.53 vs. 418.71 ± 557.75 pg/mL; p = 0.004) than in the midventricular group. In the acute phase of stress cardiomyopathy, the classic apical form of TTC is associated with poorer diastolic function compared to the midventricular ballooning variant, as assessed through direct invasive hemodynamic measurements using LHC.
- Subjects :
- Aged
Aged, 80 and over
Echocardiography
Female
France
Heart Ventricles pathology
Humans
Male
Middle Aged
Retrospective Studies
Takotsubo Cardiomyopathy pathology
Ventricular Dysfunction, Left pathology
Heart Ventricles diagnostic imaging
Takotsubo Cardiomyopathy diagnostic imaging
Ventricular Dysfunction, Left diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 35
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 31560110
- Full Text :
- https://doi.org/10.1007/s00380-019-01510-1