Diagnostic criteria for apical ballooning derived from quantitative analysis of left ventricular angiograms.
OBJECTIVE
The aim of this study was to evaluate diagnostic criteria for apical ballooning (AB) derived from quantitative analysis of left ventricular angiograms. AB is an unusual cause of left ventricular dysfunction mimicking acute transmural ischemia (STEMI).


METHODS
This study compared the systolic and diastolic linear measures of left ventricle (LV) of ten consecutive patients with AB to those obtained in a control group of STEMI patients. These measures allowed the calculation of the systolic shortening of the long and short axis of the LV.


RESULTS
Systolic short axis and long axis shortening are significantly different in the two groups, so that both the systolic and diastolic sphericity indexes (SI) were much lower in AB patients (diastolic SI: 1.62+/-0.18 vs. 1.81+/-0.16; P=0.026 and systolic SI: 1.58+/-0.22 and 2.48+/-0.54 P<0.001). Moreover, a long axis shortening >0.6 cm was 100% sensitive and specific for AB.


CONCLUSIONS
This study demonstrated that AB can be differentiated from STEMI by means of imple parameters of LV motion with a high degree of sensitivity and specificity.
Department of Cardiology, S. Bortolo Hospital, Vicenza, Italy.
L
L
La Vecchia
E
E
Cabianca
P
P
Vincenzi
L
L
Varotto
A
A
Fontanella
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000000981:diagnostic imaging