Glad to share our latest publication on #WhyCMR with T1 and T2 mapping in #takotsubo syndrome 😊with @lucarlimite @beamusumeci1 @c_eike @v_puntmann academic.oup.com/ehjcimaging/ad…
Myocardial edema largely represented, correlations with interstitial expansion, ECG changes and systolic function. Some considerations below 🧵
1/ In #takotsubo syndrome myocardial edema features the acute phase: #WhyCMR T1 and T2 mapping have the advantage of a parametric quantification of edema. T2 specific for water, but native T1 can read it too (ahajournals.org/doi/full/10.11…) and ECV not water-independent in this setting
2/ Several measurements approach were used (i.e. global, per slice, septal) with similar results obtained ➡️ septal ROI likely the best one, given higher reproducibility (ConSept study jcmr-online.biomedcentral.com/articles/10.11…)
3/ The higher the myocardial water content (⬆️native T1, T2 and ECV) the worse the systolic function. Interesting finding: basal segments had preserved circumferential strain BUT slightly increase mapping values 🟰 subtle edema.
4/ The higher the septal native T1/T2/ECV, the lower QRS voltage: mechanistic insight into a previously hypothesized mechanism (internationaljournalofcardiology.com/article/S0167-… @GuerraCardio ). However…
5/ … the classic #takotsubo sub-acute ECG with diffuse T-wave inversion and long QT seems not related to septal T2 (absolute myocardial water content) BUT rather to edema dispersion (apex-base) – replication of data obtained by using T2-STIR sequences (heartrhythmjournal.com/article/S1547-…)
6/ Overall, #WhyCMR with T1 and T2 mapping in #takotsubo gives us a lot more information than just diagnostic confirmation: a larger sample size is needed to test prognostic relevance❗️ @IngoEitel @PezelT @BeardedHeartDoc @GiuseppeMuscog @FraSantoroMD @t_stiermaier @vivimaestrini
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