MRI for the diagnosis of left ventricular apical ballooning syndrome (LVABS).
To compare MRI findings of left ventricular apical ballooning syndrome (LVABS) with those of acute myocardial infarction (AMI). Fifteen patients with a LVABS (group 1) and 25 patients with an AMI (group 2) were explored by MRI within 24 h after admission. Comparison of both groups for the number and location of myocardial segments with abnormal wall motion and abnormal perfusion or delayed enhancement was performed. The number of involved segments was higher in group 1 than in group 2 (p<0.001). In group 1, segments with abnormal wall motion were distributed in more than one vascular territory in all patients and confined to the medial, distal, and apical regions of the left ventricle. Subendocardial hypoenhancement was observed in 16/25 patients (64%) in group 2 and in none of group 1 (p<0.001). All patients in group 2 demonstrated delayed-enhancement abnormalities in a vascular distribution, whereas none in group 1 presented this abnormality (p<0.001). Diffusely distributed segmental wall-motion abnormalities and absence of first-pass perfusion hypoenhancement and of delayed enhancement at MRI help to differentiate LVABS from AMI. In the acute phase or in some difficult cases, cardiac MRI should become routine to confirm the diagnosis of LVABS.
Gerbaud
Edouard
E
Institut National de la Santé et de la Recherche Médicale, Université Bordeaux 2, F 33076 Bordeaux, France.
Montaudon
Michel
M
Leroux
Lionel
L
Corneloup
Olivier
O
Dos Santos
Pierre
P
Jaïs
Catherine
C
Coste
Pierre
P
Laurent
François
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003287:Contrast Media; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D009942:Organometallic Compounds; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis*
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine