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Cardiac magnetic resonance for assessment of cardiac involvement in Takotsubo syndrome: Do we still need contrast administration?
International Journal of Cardiology ( IF 3.2 ) Pub Date : 2020-03-19 , DOI: 10.1016/j.ijcard.2020.03.039
Emmanuelle Vermes 1 , Najete Berradja 2 , Ines Saab 2 , Thibaud Genet 3 , Philippe Bertrand 2 , Julien Pucheux 2 , Laurent Brunereau 2
Affiliation  

BACKGROUND This study evaluated the ability of T1 and T2 mapping cardiovascular magnetic resonance to assess myocardial involvement in Takotsubo syndrome (TTS). We hypothesized that non-contrast mapping techniques can be accurate and sufficient. METHODS We prospectively analysed 30 patients with TTS and 34 controls. CMR was performed a mean 5 days after the onset of symptoms and after a mean 3 month follow-up. RESULTS On admission, compared to controls, TTS patients had significantly higher global T2 values (59 ± 8 ms vs 51 ± 4 ms, p < 0.001), native T1 (1053 ± 75 ms vs 960 ± 61 ms, p < 0.001) and extracellular volume (ECV) fraction (29% ± 5 vs 23% ±3, p < 0.001). The sensitivity and specificity for T2 (cut off: 56 ms) were 62% and 97% respectively; for native T1: (cut off 1011 ms) were 72% and 91% respectively; and for ECV (cut off: 27%) were 72% and 97% respectively. Combining T2 and native T1 provided the best sensitivity (91.7%) with a good specificity (88.2%). No patients had late gadolinium enhancement. Segmental analysis showed that T2, native T1 and ECV values were significantly higher in regions with wall motion abnormalities (WMA) compared to normokinetic segments (62 ± 9 ms vs 55 ± 5 ms, p < 0.001; 1060 ± 65 ms vs 1025 ± 56 ms, p = 0.02; and 34% ± 5 vs 29% ± 1, p = 0.02). At follow up, native T1 and ECV values did not normalized. CONCLUSION In TTS patients, a non-contrast mapping technique provides a high diagnostic accuracy allowing identification of acute and persistent myocardial injury. Segmental analysis showed that myocardial injury is preferably detected in segments with WMA.

中文翻译:

心脏磁共振以评估Takotsubo综合征的心脏受累情况:我们是否仍需要对比剂管理?

背景技术这项研究评估了T1和T2映射心血管磁共振以评估心肌受累于Takotsubo综合征(TTS)的能力。我们假设非对比度映射技术可能是准确且足够的。方法我们前瞻性分析了30例TTS患者和34例对照。在症状发作后平均5天和平均3个月的随访后进行CMR。结果入院时,与对照组相比,TTS患者的整体T2值(59±8 ms vs 51±4 ms,p <0.001),天然T1(1053±75 ms vs 960±61 ms,p <0.001)和更高。细胞外体积(ECV)分数(29%±5 vs 23%±3,p <0.001)。T2的敏感性和特异性(截止:56 ms)分别为62%和97%;对于本地T1 :(截止1011 ms)分别为72%和91%;对于ECV(截止:27%)分别是72%和97%。T2和天然T1的结合提供了最佳的敏感性(91.7%)和良好的特异性(88.2%)。没有患者had的晚期增强。分段分析显示,与正常运动段相比,壁运动异常(WMA)区域的T2,天然T1和ECV值显着更高(62±9 ms vs 55±5 ms,p <0.001; 1060±65 ms vs 1025±56 ms,p = 0.02; 34%±5 vs 29%±1,p = 0.02)。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。T2和天然T1的结合提供了最佳的敏感性(91.7%)和良好的特异性(88.2%)。没有患者had的晚期增强。分段分析显示,与正常运动段相比,壁运动异常(WMA)区域的T2,天然T1和ECV值显着更高(62±9 ms vs 55±5 ms,p <0.001; 1060±65 ms vs 1025±56 ms,p = 0.02; 34%±5与29%±1,p = 0.02)。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。T2和天然T1的结合提供了最佳的敏感性(91.7%)和良好的特异性(88.2%)。没有患者had的晚期增强。分段分析表明,与正常运动段相比,壁运动异常(WMA)区域的T2,天然T1和ECV值显着更高(62±9 ms vs 55±5 ms,p <0.001; 1060±65 ms vs 1025±56 ms,p = 0.02; 34%±5 vs 29%±1,p = 0.02)。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。分段分析显示,与正常运动段相比,壁运动异常(WMA)区域的T2,天然T1和ECV值显着更高(62±9 ms vs 55±5 ms,p <0.001; 1060±65 ms vs 1025±56 ms,p = 0.02; 34%±5与29%±1,p = 0.02)。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。分段分析显示,与正常运动段相比,壁运动异常(WMA)区域的T2,天然T1和ECV值显着更高(62±9 ms vs 55±5 ms,p <0.001; 1060±65 ms vs 1025±56 ms,p = 0.02; 34%±5 vs 29%±1,p = 0.02)。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供很高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。随访时,天然T1和ECV值未标准化。结论在TTS患者中,非对比图技术可提供较高的诊断准确性,从而可以识别急性和持续性心肌损伤。分段分析显示,优选在WMA分段中检测到心肌损伤。
更新日期:2020-03-20
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