title: Takotsubo cardiomyopathy: pathogenetic insights and myocardial perfusion kinetics using myocardial contrast echocardiography.
abstract: Transient apical ballooning syndrome or Takotsubo cardiomyopathy (TC) is a novel acute cardiac syndrome, characterized by regional systolic dysfunction involving the apex and mid-ventricular segments, with hyperkinesis of the basal segments. Mid-ventricular ballooning cardiomyopathy (MVBC) is a recently recognized variant of TC. Both disorders share the same precipitating factors, clinical features and course; however, unlike TC, MVBC is characterized by ballooning and akinesis of the mid-ventricular segments with hypercontractility of the basal and apical segments. While the precise pathogenetic mechanism of this disorder remains elusive, microvascular dysfunction from excessive catecholamine release has been implicated. We report findings on regional contractile dysfunction (strain imaging), myocardial blood flow (semi-quantitative), and perfusion kinetics using myocardial contrast echocardiography in a series of three illustrative cases of TC.
authors.affiliation: Division of Cardiology, 3990 John R, 8 Brush, Harper University Hospital, Wayne State University, Detroit Medical Center, Detroit, MI 48201, USA. lafonso@med.wayne.edu
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
authors.forename: Khaled
authors.initials: K
authors.lastname: Bachour
authors.forename: Khaled
authors.initials: K
authors.lastname: Awad
authors.forename: Greg
authors.initials: G
authors.lastname: Sandidge
mesh_terms: D000328:Adult; D003326:Coronary Circulation; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D005466:Fluorocarbons; D006801:Humans; D008297:Male; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D005466:Fluorocarbons; C042852:perflutren