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Cardiac sympathetic activity in hypertrophic cardiomyopathy and Tako-tsubo cardiomyopathy.

Verschure DO, van Eck-Smit BL, Somsen GA, Verberne HJ - Clin Transl Imaging (2015)

Bottom Line: This overview shows the clinical value of (123)I-mIBG scintigraphy in two types of primary cardiomyopathy: The genetic hypertrophic cardiomyopathy (HCM) and the acquired Tako-tsubo cardiomyopathy (TCM).In addition, (123)I-mIBG scintigraphy may be useful for determining the risk of developing congestive heart failure and ventricular tachycardia in these patients.In addition, (123)I-mIBG scintigraphy may identify those patients who are prone to TCM recurrence and may help to identify responders to individual (pharmacological) therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands ; Department of Cardiology, Medical Center Alkmaar, Alkmaar, The Netherlands.

ABSTRACT

(123)I-meta-iodobenzylguanidine ((123)I-mIBG) scintigraphy has been established as an important technique to evaluate cardiac sympathetic function and it has been shown to be of clinical value, especially for the assessment of prognosis, in many cardiac diseases. The majority of (123)I-mIBG scintigraphy studies have focused on patients with cardiac dysfunction due to hypertension, ischemic heart disease, or valvular disease. However less is known about the role of (123)I-mIBG scintigraphy in primary cardiomyopathies. This overview shows the clinical value of (123)I-mIBG scintigraphy in two types of primary cardiomyopathy: The genetic hypertrophic cardiomyopathy (HCM) and the acquired Tako-tsubo cardiomyopathy (TCM). Cardiac sympathetic activity is increased in HCM and correlates to the septal wall thickness and consequently to the LVOT obstruction. Moreover, increased cardiac sympathetic activity correlates with impaired diastolic and systolic LV function. In addition, (123)I-mIBG scintigraphy may be useful for determining the risk of developing congestive heart failure and ventricular tachycardia in these patients. In TCM (123)I-mIBG scintigraphy can be used to assess cardiac sympathetic hyperactivity. In addition, (123)I-mIBG scintigraphy may identify those patients who are prone to TCM recurrence and may help to identify responders to individual (pharmacological) therapy.

No MeSH data available.


Related in: MedlinePlus

Examples of Tako-tsubo cardiomyopathy assessed with echocardiography (a) and MRI (b) showing typical apical ballooning with hyperkinesia of the basal segments and dyskinesia of the apical segments of the LV
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Fig2: Examples of Tako-tsubo cardiomyopathy assessed with echocardiography (a) and MRI (b) showing typical apical ballooning with hyperkinesia of the basal segments and dyskinesia of the apical segments of the LV

Mentions: TCM, also known as stress-induced cardiomyopathy, apical ballooning syndrome or broken heart syndrome was first described in Japan in 1990 [41]. It is characterized by transient systolic dysfunction of apical and/or mid segments accompanied with ballooning of these segments. Importantly, most often wall motion abnormalities extent beyond the distribution of any single coronary artery. The clinical presentation can mimic acute myocardial infarction, in the absence of obstructive coronary artery disease. The Japanese phrase ‘tako-tsubo’ can be translated in English as ‘octopus pot’, a fishing jar with a narrow neck and wide base used to trap an octopus. This description reflects the visual appearance of the heart on left ventriculography or echocardiography (Fig. 2). Considerable evidence points to epinephrine as an important factor in the pathophysiology [42]. In the acute phase of TCM, plasma epinephrine levels are more elevated compared with the acute phase of a myocardial infarction [43].Fig. 2


Cardiac sympathetic activity in hypertrophic cardiomyopathy and Tako-tsubo cardiomyopathy.

Verschure DO, van Eck-Smit BL, Somsen GA, Verberne HJ - Clin Transl Imaging (2015)

Examples of Tako-tsubo cardiomyopathy assessed with echocardiography (a) and MRI (b) showing typical apical ballooning with hyperkinesia of the basal segments and dyskinesia of the apical segments of the LV
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4592489&req=5

Fig2: Examples of Tako-tsubo cardiomyopathy assessed with echocardiography (a) and MRI (b) showing typical apical ballooning with hyperkinesia of the basal segments and dyskinesia of the apical segments of the LV
Mentions: TCM, also known as stress-induced cardiomyopathy, apical ballooning syndrome or broken heart syndrome was first described in Japan in 1990 [41]. It is characterized by transient systolic dysfunction of apical and/or mid segments accompanied with ballooning of these segments. Importantly, most often wall motion abnormalities extent beyond the distribution of any single coronary artery. The clinical presentation can mimic acute myocardial infarction, in the absence of obstructive coronary artery disease. The Japanese phrase ‘tako-tsubo’ can be translated in English as ‘octopus pot’, a fishing jar with a narrow neck and wide base used to trap an octopus. This description reflects the visual appearance of the heart on left ventriculography or echocardiography (Fig. 2). Considerable evidence points to epinephrine as an important factor in the pathophysiology [42]. In the acute phase of TCM, plasma epinephrine levels are more elevated compared with the acute phase of a myocardial infarction [43].Fig. 2

Bottom Line: This overview shows the clinical value of (123)I-mIBG scintigraphy in two types of primary cardiomyopathy: The genetic hypertrophic cardiomyopathy (HCM) and the acquired Tako-tsubo cardiomyopathy (TCM).In addition, (123)I-mIBG scintigraphy may be useful for determining the risk of developing congestive heart failure and ventricular tachycardia in these patients.In addition, (123)I-mIBG scintigraphy may identify those patients who are prone to TCM recurrence and may help to identify responders to individual (pharmacological) therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands ; Department of Cardiology, Medical Center Alkmaar, Alkmaar, The Netherlands.

ABSTRACT

(123)I-meta-iodobenzylguanidine ((123)I-mIBG) scintigraphy has been established as an important technique to evaluate cardiac sympathetic function and it has been shown to be of clinical value, especially for the assessment of prognosis, in many cardiac diseases. The majority of (123)I-mIBG scintigraphy studies have focused on patients with cardiac dysfunction due to hypertension, ischemic heart disease, or valvular disease. However less is known about the role of (123)I-mIBG scintigraphy in primary cardiomyopathies. This overview shows the clinical value of (123)I-mIBG scintigraphy in two types of primary cardiomyopathy: The genetic hypertrophic cardiomyopathy (HCM) and the acquired Tako-tsubo cardiomyopathy (TCM). Cardiac sympathetic activity is increased in HCM and correlates to the septal wall thickness and consequently to the LVOT obstruction. Moreover, increased cardiac sympathetic activity correlates with impaired diastolic and systolic LV function. In addition, (123)I-mIBG scintigraphy may be useful for determining the risk of developing congestive heart failure and ventricular tachycardia in these patients. In TCM (123)I-mIBG scintigraphy can be used to assess cardiac sympathetic hyperactivity. In addition, (123)I-mIBG scintigraphy may identify those patients who are prone to TCM recurrence and may help to identify responders to individual (pharmacological) therapy.

No MeSH data available.


Related in: MedlinePlus