Large anterior wall myocardial infarction with impaired left ventricular function is associated with increased stroke rate.
Apical ballooning and temporal anterior wall dysfunction in Takotsubo syndrome (TTS) may also lead to a higher risk for acute cardioembolic complications.
Aim of this study was to evaluate recovery of left ventricular dysfunction and anterior wall abnormalities and to observe outcome of TTS in particular stroke rates within 30 days.
Methods and Materials
We identified 72 patients with TTS in our tertiary care center from January 2005 until March 2017 in which we routinely performed cardiovascular magnetic resonance imaging (CMR).
TTS diagnosis was based on the proposed Mayo Clinic diagnostic criteria.
Patients with history of myocardial infarction,
coronary bypass surgery and congenital heart disease were excluded.
Acute stroke and major adverse clinical events (MACE) defined as a composite of myocardial infarction or recurrence of TTS and...
We analyzed left ventricular CMR parameters and outcome of 72 patients with a mean age of 68.8±17.5 years.
The majority were female patients (93%).
Initial CMR was performed in all patients 2 days after the index event (median: 2d; IQR 1-4).
CMR follow-up scan was conducted 2.3 months later (IQR 1.3-2.9) in 63 (88%) patients.
Anterior wall dysfunction was initially observed in 65 patients and resolved in 97%.
Median left ventricular ejection fraction significantly increased between both scans...
Anterior wall motion dysfunction and left ventricular function recovered significantly in the majority of patients with TTS after two months.
Transient dysfunction of the anterior wall resulting in apical ballooning in TTS with increased stroke rates may lead to the hypothesis that anticoagulation has a protective effect.
we suggest oral anticoagulation for two months or at least until recovery of left ventricular function against acute stroke in TTS.
Prospective studies need to be...