title: Evaluation of transient apical ballooning with cardiac magnetic resonance imaging and 31-phosphorous magnetic resonance spectroscopy.
abstract: Apical ballooning is an increasingly reported transient cardiomyopathy with yet unknown origin. In this study 2 cases of apical ballooning are described in whom we used a combined approach of cardiac magnetic resonance imaging (CMR) and 31-Phosphorous magnetic resonance spectroscopy (31P MRS). Electrocardiogram showed ST abnormalities and cardiac serum markers were mildly elevated, but CAG demonstrated smooth coronary arteries. Cine-CMR revealed severe apical akinesia and significantly decreased ejection fraction. Furthermore we detected reduced myocardial phosphocreatine to beta-ATP (PCr/b-ATP) ratios during the first week of acute disease. After 1 week we observed an improvement of PCr/b-ATP ratios by 68% and 34%, which was associated with an increase in left ventricular function. Our data suggest that 31P MRS might be a valuable tool in the evaluation of apical ballooning, but larger cohorts are needed to improve the understanding of metabolic changes during transient apical ballooning.
authors.forename: G
authors.initials: G
authors.lastname: Klug
authors.forename: C
authors.initials: C
authors.lastname: Wolf
authors.forename: T
authors.initials: T
authors.lastname: Trieb
authors.forename: M
authors.initials: M
authors.lastname: Frick
authors.forename: A
authors.initials: A
authors.lastname: Koehler
authors.forename: M F
authors.initials: MF
authors.lastname: Schocke
authors.forename: W
authors.initials: W
authors.lastname: Jaschke
authors.forename: O
authors.initials: O
authors.lastname: Pachinger
authors.forename: B
authors.initials: B
authors.lastname: Metzler
mesh_terms: D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009682:Magnetic Resonance Spectroscopy / Q000295:instrumentation / Q000379:methods*; D010759:Phosphorus Isotopes; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
chemical_list: D010759:Phosphorus Isotopes