Key result
Myocardial perfusion scintigraphy emerges as the most common nuclear imaging technique for atypical Takotsubo cardiomyopathy.
Why the study?
Atypical variants of Takotsubo cardiomyopathy sparing the left ventricular apex have emerged, but a comprehensive overview of cardiac nuclear imaging findings in these variants was needed.
What are the cardiac nuclear imaging findings in atypical variants of Takotsubo cardiomyopathy?
Systematic Review (n=14)
What are the cardiac nuclear imaging findings in atypical variants of Takotsubo cardiomyopathy?
This systematic review summarizes the use of cardiac nuclear imaging in atypical Takotsubo cardiomyopathy, highlighting myocardial perfusion scintigraphy as the most common modality and the midventricular form as the most frequent variant.
Nuclear imaging, led by myocardial perfusion scintigraphy, is feasible in atypical Takotsubo; leaves open standardization and prospective validation of protocols.
Background: In addition to the typical form resembling the classical Japanese octopus trap, atypical variants of Takotsubo cardiomyopathy (TTC) sparing the left ventricular apex have emerged over the years. The aim of this systematic review is to provide a comprehensive overview of the cardiac nuclear imaging findings in atypical variants. Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The literature research was carried out online on the Pubmed, Scopus, Central (Cochrane Library), and Web Of Science databases. Results: A total of 14 articles were ultimately selected. Myocardial perfusion scintigraphy was performed in nine studies, followed by 123I-mIBG scintigraphy, 123I-BMIPP scintigraphy, and 18F-FDG PET. In seven cases, a single cardiac nuclear imaging technique was performed, while in the remaining five and two cases, two and three different imaging modalities were, respectively, used. The most common atypical variant of our selection was the midventricular form, followed by reverse/inverted/basal TTC, with only a single case reported of a focal pattern. Conclusions: As the reason why TTC variants occur is still not clear, a deeper understanding of the current knowledge could be the basis for providing more insights into this fascinating disorder and its uncommon manifestations.
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Feo et al. (2024) conducted a systematic review in Atypical variants of Takotsubo cardiomyopathy (n=14). Cardiac nuclear imaging was evaluated on Cardiac nuclear imaging findings. Cardiac nuclear imaging in atypical Takotsubo cardiomyopathy was evaluated in 14 articles, with myocardial perfusion scintigraphy being the most frequently performed technique (9 studies).
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