Marco Francone MD, Presenter: Nothing to Disclose

Giuseppe Cannavale MD, Abstract Co-Author: Nothing to Disclose

Bettina Conti, Abstract Co-Author: Nothing to Disclose

Ilaria Iampieri, Abstract Co-Author: Nothing to Disclose

Carlo Catalano MD, Abstract Co-Author: Nothing to Disclose

Iacopo Carbone MD, Abstract Co-Author: Nothing to Disclose

The main hallmark of TT-CMP disease is characterized by a transitory ischemia with completely reversibile regional contractile dysfunction involving apical segments and with no angiographic signs of coronary artery disease. The acute inflammatory and reversible nature of myocardial damage suggest that tissue edema may be a relevant marker of disease.

17 patients with clinical and angiographic diagnosis of TT-CMP underwent CMR in the acute phase (mean 2.4 days) and at 4 months follow-up. In all patients a standard acquisition protocol including TSE T2-weighted short-tau inversion recovery (T2w-STIR), cine-SSFP and delayed enhancement (DE) imaging post-Gd-BOPTA was acquired. Images were visually analyzed for presence of edema and late enhancement data were correlated with regional dysfunction assessed with cine-SSFP. Endomyocardial biopsy was available in 7 cases.

In all patients, T2-STIR images showed the presence of an homogeneous diffuse hyperintensity reflecting tissue edema, entirely involving the mid-apical segments and perfectly matching with the area of regional dysfunction; no cases of DE were observed. At follow-up complete regression of edema was observed in all cases with a significant recovery of regional and global LV function (ejection fraction from 47,2±8,4% to 64,3±6,2%).

Myocardial edema is a feature of acute TT-CMP likely reflecting the acute inflammation and vasoactive phenomena associated with the syndrome and could be used as a marker of disease severity. CMR allows its detection non-invasively.

Myocardial edema could be used as a marker of disease severity in patients with TT-CMP

Francone, M, Cannavale, G, Conti, B, Iampieri, I, Catalano, C, Carbone, I, Myocardial Edema as the Sole Marker of Acute Injury in Tako-Tsubo Cardiomiopathy (TT-CMP): A Cardiovascular Magnetic Resonance (CMR) Study.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016022.html