Document Detail

A pathophysiologic study of tako-tsubo cardiomyopathy with F-18 fluorodeoxyglucose positron emission tomography.
MedLine Citation:
PMID:  17921529     Owner:  NLM     Status:  MEDLINE    
METHODS AND RESULTS: Fifteen patients with tako-tsubo cardiomyopathy were enrolled in this study. Plasma catecholamines, cardiac troponin T (cTnT), and D-dimer were serially evaluated in all patients. Thallium-201 ((201)Tl) single-photon emission computed tomography (SPECT) and F-18 FDG PET were performed in 10 and eight patients, respectively. Emotional or physical stress occurred in 12 (80.0%) patients. ST-T segment abnormalities existed in all patients. Thirteen patients exhibited mildly elevated cTnT, although coronary angiography did not reveal significant stenosis in any patient. Endomyocardial biopsy specimens (n = 9) demonstrated contraction-band necrosis (n = 4) and mononuclear cell infiltration (n = 3). The levels of norepinephrine and epinephrine peaked on admission (744 +/- 452 and 140 +/- 166 pg/mL, respectively). There was severely reduced uptake at the apex on F-18 FDG PET image, despite slightly reduced uptake of (201)Tl. Elevation of D-dimer was observed in nine patients.
CONCLUSION: The extent of metabolic defect involving apical akinetic area was more severe than perfusion abnormality. Our data suggest that sudden emotional or physical stress may cause a catecholamine-induced metabolic disorder in the myocardium, which is probably central to this syndrome.
Tetsuro Yoshida; Takeshi Hibino; Nobuo Kako; Shunsuke Murai; Mitsutoshi Oguri; Kimihiko Kato; Kazuhiro Yajima; Nobuyuki Ohte; Kiyoshi Yokoi; Genjiro Kimura
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-10-07
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-11-02     Completed Date:  2008-06-19     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2598-604     Citation Subset:  IM    
Department of Cardiovascular Medicine, Gifu Prefectural Government Tajimi Hospital, 5-161 Maehata, Tajimi, Gifu 5078522, Japan.
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MeSH Terms
Aged, 80 and over
Biological Markers / blood
Cardiac Catheterization / methods
Catecholamines / blood
Coronary Angiography / methods
Echocardiography / methods
Electrocardiography / methods
Fibrin Fibrinogen Degradation Products / metabolism
Fluorodeoxyglucose F18 / diagnostic use
Positron-Emission Tomography / methods*
Radiopharmaceuticals / diagnostic use
Takotsubo Cardiomyopathy / etiology,  metabolism,  radionuclide imaging*
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon / methods*
Troponin T / blood
Reg. No./Substance:
0/Biological Markers; 0/Catecholamines; 0/Fibrin Fibrinogen Degradation Products; 0/Radiopharmaceuticals; 0/Thallium Radioisotopes; 0/Troponin T; 0/fibrin fragment D; 63503-12-8/Fluorodeoxyglucose F18
Comment In:
Eur Heart J. 2008 Mar;29(5):681; author reply 681-2   [PMID:  18238929 ]
Eur Heart J. 2008 Apr;29(8):1072; author reply 1072-3   [PMID:  18308690 ]

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