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Comparison of Left Ventricular Contractile Abnormalities in Stress‐Induced Cardiomyopathy versus Obstructive Coronary Artery Disease Using Two‐Dimensional Strain Imaging
Author(s) -
Briasoulis Alexandros,
Marinescu Karolina,
Mocanu Marian,
Sattar Assad,
Qaqi Osama,
Cardozo Shaun,
Kottam Anupama,
Afonso Luis
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13178
Subject(s) - cardiology , medicine , coronary artery disease , strain (injury) , cardiomyopathy , basal (medicine) , diastole , heart failure , blood pressure , insulin
Background Data on left ventricular (LV) strain profiles in patients with takotsubo cardiomyopathy (TC) in comparison with obstructive coronary artery disease (CAD) are limited. We sought to investigate regional and global LV longitudinal strain in a cohort of patients with known TC using two‐dimensional strain imaging (2DS) in comparison with patients with acute cardiomyopathy (ACM) due to severe obstructive left anterior descending arterial disease or triple‐vessel disease and healthy controls. Methods Transthoracic echocardiography was performed in 34 patients with established TC, 24 patients with ACM, and 30 healthy subjects. We measured the segmental longitudinal strain in apical views by the use of EchoInsight Epsilon software. Left ventricular global longitudinal strain (GLS) was calculated by averaging segmental wall strains. Results The TC and ACM groups were comparable for age and demographic characteristics. Systolic and diastolic function were significantly impaired in both groups compared to controls. LV global and segmental systolic strain was also significantly attenuated in patients with TC and ACM compared to controls (P < 0.001). Moreover, LV basal segmental longitudinal strain was higher in the patients with TC compared to ACM (P = 0.02). Global and apical segmental strain appear to be higher in patients with mid‐ventricular variant compared to those with apical variant of TC with apical strain cutoff value of −7.85%, offering the best discriminatory value for differentiating these two patterns (P = 0.001). Conclusions The results of this hypothesis‐generating study indicate that longitudinal LV strain parameters are similarly impaired in patients with TC and ACM due to severe obstructive left anterior descending arterial disease or triple‐vessel disease. Assessment of two‐dimensional LV strain parameters could help differentiate between different TC patterns.