Key result
In acute takotsubo syndrome, higher T2 mapping values were independently associated with lack of emotional trigger (p=0.031), decreasing LVEF (p=0.024), and increasing GEIST score (p=0.024).
Why the study?
Clinical correlates of myocardial edema, a key feature of acute takotsubo syndrome assessed quantitatively by T2 mapping cardiac magnetic resonance, are not well characterized.
What are the clinical correlates of myocardial edema assessed by T2 mapping CMR in patients with acute Takotsubo syndrome?
Observational (n=60)
What are the clinical correlates of myocardial edema assessed by T2 mapping CMR in patients with acute Takotsubo syndrome?
In acute Takotsubo syndrome, myocardial edema quantified by T2 mapping CMR correlates with disease severity and high-risk clinical features.
T2 mapping may aid edema assessment in acute TTS; leaves open incremental value over GEIST-score for risk stratification.
BACKGROUND: Extensive myocardial edema is a key feature of acute takotsubo syndrome (TTS) and it can be quantitatively assessed by T2 mapping cardiac magnetic resonance (CMR) imaging. Clinical correlates of myocardial edema in TTS are not well characterized. METHODS: Sixty patients with acute TTS underwent CMR with T2 mapping within one week of hospitalization. Disease severity was assessed by a validated risk score (GEIST-score). RESULTS: Mean age of the study population was 71 ± 12 years (92 % females). Mean mid-septal T2 time was 58 ± 6 ms. Higher T2 mapping values were found in patients with left ventricular ejection fraction (LVEF) ≤40 % (60 ± 6 ms vs 56 ± 5 ms; p = 0.006), male sex (66 ± 7 ms vs 58 ± 6 ms; p = 0.010), dyspnea on admission (63 ± 7 ms vs 58 ± 6 ms; p = 0.006), absence of an emotional trigger (60 ± 7 ms vs 57 ± 5 ms; p = 0.039), intermediate-to-severe GEIST-score (63 ± 7 ms vs 58 ± 6 ms; p = 0.045) and in-hospital complications (61 ± 1 ms vs 58 ± 6 ms; p = 0.009). A trend towards higher values was observed in patients who died at follow-up (62 ± 8 ms vs 58 ± 6 ms; p = 0.098). On linear regression analysis, T2 mapping did not correlate with the timing of CMR (Beta -0.182, p = 0.170), whereas after multivariable correction, lack of emotional trigger (Beta 0.262, p = 0.031), decreasing LVEF (Beta -0.254, p = 0.024) and increasing GEIST score (Beta 0.282, p = 0.024) remained independently associated with T2 mapping. CONCLUSIONS: In patients with acute TTS undergoing a timely CMR within the first week after admission, T2 mapping was not affected by timing of the examination, was higher in patients displaying high-risk features, and independently associated with the GEIST risk score.
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Arcari et al. (2024) conducted an observational in acute takotsubo syndrome (TTS) (n=60). High-risk clinical features (LVEF ≤40%, lack of emotional trigger, high GEIST score) vs. Absence of high-risk features was evaluated on T2 mapping values (myocardial edema). In acute takotsubo syndrome, higher T2 mapping values were independently associated with lack of emotional trigger (p=0.031), decreasing LVEF (p=0.024), and increasing GEIST score (p=0.024).
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