Abstract 18154: Can Longitudinal Strain Profile Reliably Distinguish Takotsubo Cardiomyopathy from Acute LAD Territory MI?: Analysis Using Speckle Tracking Imaging
Background: Stress cardiomyopathy (SC) is an increasingly recognized syndrome. However after nearly 3 decades of study, it is still challenging to discriminate SC from acute left anterior descending artery (LAD-MI) at presentation by transthoracic echocardiography (TTE), let alone clinically.
Objective: to characterize global and regional left ventricular (LV) function using two-dimensional (2D) strain imaging
Methods: We studied 22 female patients; 12 with apical variant SC and 10 LAD-MI pts. All pts underwent TTE and cardiac catheterization within 48h of the hospital admission. 2D longitudinal strain analysis from the 3 standard apical views (total of 18 segments per patient) was performed in a blinded fashion. Global longitudinal strain (GLS) was the average of all 18 segments.
Results: The mean age (SC 62.7 ± 7.1 vs. MI 55.4 ± 14 yrs) and LVEF (SC 44.3 ± 8.7 vs. MI 44.0 ± 11.0 %) were not different between groups. When compared to SC, MI pts had a significantly higher troponin (31.9 ± 9.4 vs. 2.6 ± 0.65 ng/dl, p<0.05) and higher systolic BP (130 ± 22 vs. 111 ± 16 mmHg, p<0.05). 2D starin analysis was feasible in 85% of the segments. Longitudinal strain in the basal inferior segment was higher in the MI vs. the SC group (–22.19±6.7 vs. –13.24±8.5 %, p<0.05), whereas longitudinal strain in the mid anterior wall was lower in the MI vs. the SC group (–10.8 ±5.7 vs. –16.8±5.6 % %, p<0.05). All the other 16 segments and GLS values were similar between the 2 groups.
Conclusion: 2D segmental longitudinal strain is significantly different between apical variant SC and anterior MI patients. This observation highlights the potential utility of 2D strain in differentiating SC from MI and has important clinical implications.
Author Disclosures: M. Ahmed: None. T.P. Fitzgibbons: Research Grant; Significant; Fellow to Faculty Award, National Affiliate. P. Shaw: None. A. Iskandar: None. J. Escobar Valle: None. J. Bote: None. D. Tighe: None. G.P. Aurigemma: None.
- © 2014 by American Heart Association, Inc.