Atrial mechanics and their prognostic impact in Takotsubo syndrome: a cardiovascular magnetic resonance imaging study

• Published in: European heart journal cardiovascular imaging 2019-09, Vol.20 (9), p.1059-1069
• Main Authors: Backhaus, Sören J, Stiermaier, Thomas, Lange, Torben, Chiribiri, Amedeo, Uhlig, Johannes, Freund, Anne, Kowallick, Johannes T, Gertz, Roman J, Bigalke, Boris, Villa, Adriana, Lotz, Joachim, Hasenfuß, Gerd, Thiele, Holger, Eitel, Ingo, Schuster, Andreas
• Format: Article
• Language: English
• ISSN: 2047-2404; 2047-2412
• DOI: 10.1093/ehjci/jey219

Abstract Aims The exact pathophysiology of Takotsubo syndrome (TTS) remains not fully understood with most studies focussing on ventricular pathology. Since atrial involvement may have a significant role, we assessed the diagnostic and prognostic potential of atrial cardiovascular magnetic resonance feature tracking (CMR-FT) in TTS. Methods and results This multicentre study recruited 152 TTS patients who underwent CMR on average within 3 days after hospitalization. Reservoir [total strain εs and peak positive strain rate (SR) SRs], conduit (passive strain εe and peak early negative SRe), and booster pump function (active strain εa and peak late negative SRa) were assessed in a core laboratory. Results were compared with 21 control patients with normal biventricular function. A total of 20 patients underwent follow-up CMR (median 3.5 months, interquartile range 3–5). All patients were approached for general follow-up. Left atrial (LA) but not right atrial (RA) reservoir and conduit function were impaired during the acute phase (εs: P = 0.043, εe: P