Abnormal response to mental stress in patients with Takotsubo cardiomyopathy detected by gated single photon emission computed tomography
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Persistent abnormalities are usually not detected in patients with Takotsubo cardiomyopathy (TTC). Since sympathetically mediated myocardial damage has been proposed as a causative mechanism of TTC, we explored whether mental stress could evoke abnormalities in these patients.
One month after an acute event, 22 patients fulfilling all TTC diagnostic criteria and 11 controls underwent resting and mental stress gated single photon emission computed tomography (SPECT). Perfusion, wall motion, transient ischaemic dilation (TID) and left ventricular (LV) ejection fraction (EF) were evaluated.
None of the controls showed stress-induced abnormalities. Mental stress evoked regional changes (perfusion defects and/or wall motion abnormality) in 16 TTC subjects and global abnormalities (LVEF fall >5% and/or TID >1.10) in 13; 3 had a completely negative response. TID, delta LVEF and delta wall motion score were significantly different in TTC vs control patients: 1.08 ± 0.20 vs 0.95 ± 0.11 (p < 0.05), −1.7 ± 6% vs 4 ± 5% (p < 0.02) and 2.5 (0, 4.25) vs 0 (0, 0) (p < 0.002), respectively.
Mental stress may evoke regional and/or global abnormalities in most TTC patients. The abnormal response to mental stress supports the role of sympathetic stimulation in TTC. Mental stress could thus be helpful for TTC evaluation.
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- Abnormal response to mental stress in patients with Takotsubo cardiomyopathy detected by gated single photon emission computed tomography
European Journal of Nuclear Medicine and Molecular Imaging
Volume 37, Issue 4 , pp 765-772
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Gated single photon emission computed tomography
- Mental stress
- Takotsubo cardiomyopathy
- Industry Sectors
- Author Affiliations
- 1. Nuclear Medicine Unit, Department of Clinical Physiopathology, University of Florence, Viale Morgagni 85, 50134, Florence, Italy
- 2. Division of Cardiology, Careggi Hospital, Florence, Italy
- 3. Department of Heart and Vessels, Unit of General Cardiology, Careggi Hospital, Florence, Italy