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MRI for the diagnosis of left ventricular apical ballooning syndrome (LVABS)

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Abstract

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.

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Authors and Affiliations

  1. Institut National de la Santé et de la Recherche Médicale U885 (MM, FL) and U441 (PC, PDS, LL), Université Bordeaux 2, F 33076, Bordeaux, France

    Edouard Gerbaud, Michel Montaudon, Lionel Leroux, Olivier Corneloup, Catherine Jaïs, Pierre Coste & François Laurent

  2. Hôpital du Haut-Lévêque, Unité d’Imagerie Thoracique et Cardiovasculaire (M.M., F.L., O.C.), Unité de soins intensifs cardiologiques (EG, PC, LL, CJ), Centre Hospitalier Universitaire de Bordeaux, Hôpital Cardiologique, avenue de Magellan, F 33604, Pessac, France

    Edouard Gerbaud, Michel Montaudon, Lionel Leroux, Olivier Corneloup, Pierre Dos Santos, Catherine Jaïs, Pierre Coste & François Laurent

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  1. Edouard Gerbaud
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  2. Michel Montaudon
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  3. Lionel Leroux
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  4. Olivier Corneloup
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  5. Pierre Dos Santos
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  6. Catherine Jaïs
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  7. Pierre Coste
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  8. François Laurent
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Correspondence to Michel Montaudon.

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Gerbaud, E., Montaudon, M., Leroux, L. et al. MRI for the diagnosis of left ventricular apical ballooning syndrome (LVABS). Eur Radiol 18, 947–954 (2008). https://doi.org/10.1007/s00330-008-0853-9

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  • DOI: https://doi.org/10.1007/s00330-008-0853-9

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