Extensive myocardial stunning can be associated with prolonged sympathetic nerve injury, as evidenced by delayed normalization of MIBG imaging and T wave inversions.
May indicate extended sympathetic recovery after stunning; hypothesis-generating and should not yet change practice.
A 69-year-old woman was admitted to the hospital with palpitations. Although left ventriculography showed extensive akinesis except in the basal hyperkinetic segment, coronary angiography showed normal coronary arteries. 123I-metaiodobenzylguanidine (MIBG) accumulation was obviously reduced in the anteroseptal, apical and inferior areas. Inverted T waves developed on day 3 and disappeared on day 104 after transient regression. Echocardiography showed normal left ventricular motion two weeks later. Ergonovine provocation test showed no vasospasm and thallium-201 showed no perfusion defect on day 46. Electrocardiography and MIBG returned to normal on day 216. These findings suggest prolonged sympathetic nerve injury in extensive myocardial stunning.
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Sato et al. (2001) studied this question.
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