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Taku-tsubo cardiomyopathy not always tied to apical ballooning
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
In the small minority of patients with troponin-positive acute coronary syndrome (ACS) who develop transient reversible left ventricular dysfunction, not all exhibit typical apical ballooning, according to German researchers.
In the small minority of patients with troponin-positive acute coronary syndrome (ACS) who develop transient reversible left ventricular dysfunction, not all exhibit typical apical ballooning, according to German researchers.
"Transient cardiomyopathy, also termed tako-tsubo cardiomyopathy, does not exclusively affect the apex of the heart," senior investigator Dr. Peter Radke told Reuters Health. "In up to 40 per cent of patients, a midventricular wall motion abnormality is seen. Transient cardiomyopathy therefore should no longer be regarded as the 'apical ballooning syndrome'."
As reported in the September issue of Chest, Dr. Radke of the University of Schleswig-Holstein, Lubeck and colleagues examined the potential differences between patients with apical and midventricular ballooning.
The researchers studied data on 2944 patients with ACS and found that 35 (1.2 per cent) had transient cardiomyopathy. Typical apical wall motion abnormality was seen in 21 (60 per cent) and an atypical midventricular pattern was seen in the remaining 14 (40 per cent).
Given these findings, the researchers conclude that the syndrome should be considered as one which has "a transient left ventricular dysfunction syndrome with an apical or midventricular pattern of wall motion abnormality."
In an accompanying editorial, Dr. Norbert Frey and colleagues at the University of Heidelberg note that the term tako-tsubo was coined by Japanese investigators who likened the left ventricular appearance on angiography to that of an octopus trap.
In light of the findings, the editorialists agree that the term "apical ballooning as a synonym for tako-tsubo syndrome is a misnomer because it reflects only part of the patient population and, in our view, should be avoided.
"Transient cardiomyopathy, also termed tako-tsubo cardiomyopathy, does not exclusively affect the apex of the heart," senior investigator Dr. Peter Radke told Reuters Health. "In up to 40 per cent of patients, a midventricular wall motion abnormality is seen. Transient cardiomyopathy therefore should no longer be regarded as the 'apical ballooning syndrome'."
As reported in the September issue of Chest, Dr. Radke of the University of Schleswig-Holstein, Lubeck and colleagues examined the potential differences between patients with apical and midventricular ballooning.
The researchers studied data on 2944 patients with ACS and found that 35 (1.2 per cent) had transient cardiomyopathy. Typical apical wall motion abnormality was seen in 21 (60 per cent) and an atypical midventricular pattern was seen in the remaining 14 (40 per cent).
Given these findings, the researchers conclude that the syndrome should be considered as one which has "a transient left ventricular dysfunction syndrome with an apical or midventricular pattern of wall motion abnormality."
In an accompanying editorial, Dr. Norbert Frey and colleagues at the University of Heidelberg note that the term tako-tsubo was coined by Japanese investigators who likened the left ventricular appearance on angiography to that of an octopus trap.
In light of the findings, the editorialists agree that the term "apical ballooning as a synonym for tako-tsubo syndrome is a misnomer because it reflects only part of the patient population and, in our view, should be avoided.
