title: Takotsubo cardiomyopathy: an integrated multi-imaging approach.
abstract: Takotsubo cardiomyopathy (TTC) is a distinct clinical entity characterized by the presence of transient left ventricular wall dysfunction without significant culprit obstructive coronary artery disease. Invasive coronary angiography and ventriculography are the 'gold standard' for definitive diagnosis, with an integrated multi-modality imaging approach offering advantages in various clinical scenarios. Echocardiography is a widely available, first-line, non-invasive imaging technique appropriate both in emergency setting to confirm diagnosis, assess for various potential acute complications, and in serial follow-up to track myocardial recovery. Cardiac magnetic resonance (CMR) may be helpful to discriminate TTC from other acute cardiac syndromes with troponin elevation and ventricular dysfunction. Echocardiography, CMR, and nuclear imaging may also provide new insights into possible underlying pathophysiological mechanisms, and myocardial (123)I-metaiodobenzyl-guanidine imaging may have a role for retrospective diagnosis in the subacute phase of late-presenting cases. The potential diagnostic role of coronary computed tomography angiography in the emergency room requires a further study.
authors.affiliation: Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.forename: Alexander
authors.initials: A
authors.lastname: Lyon
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.forename: Anastasios
authors.initials: A
authors.lastname: Athanasiadis
authors.forename: Patrick
authors.initials: P
authors.lastname: Meimoun
authors.forename: Guido
authors.initials: G
authors.lastname: Parodi
authors.forename: Sèbastien
authors.initials: S
authors.lastname: Cimarelli
authors.forename: Elmir
authors.initials: E
authors.lastname: Omerovic
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrara
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Limongelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Cittadini
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Salerno-Uriarte
authors.forename: Pasquale
authors.initials: P
authors.lastname: Perrone Filardi
authors.forename: Birke
authors.initials: B
authors.lastname: Schneider
authors.forename: Udo
authors.initials: U
authors.lastname: Sechtem
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000465:Algorithms; D017023:Coronary Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods; D019560:Echocardiography, Three-Dimensional / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D019788:Fluorodeoxyglucose F18; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000175:diagnosis; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000503:physiopathology; D015899:Tomography, Emission-Computed, Single-Photon; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: cardiac imaging; pathophysiology; takotsubo cardiomyopathy