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Arch Cardiovasc Dis. 2010 Aug-Sep;103(8-9):447-53. doi: 10.1016/j.acvd.2010.08.001. Epub 2010 Oct 25.

Diagnostic value of contrast echocardiography in Tako-Tsubo cardiomyopathy.

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  • 1Service de Cardiologie, Hôpital Universitaire Ambroise-Paré, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Versailles-Saint-Quentin (UVSQ), 92100 Boulogne, France. nicolas.mansencal@apr.aphp.fr

Abstract

BACKGROUND:

Tako-Tsubo cardiomyopathy is a clinical entity mimicking acute coronary syndrome. Assessment of left ventricular function may be difficult using conventional echocardiography.

AIMS:

to characterize left ventricular systolic function using contrast echocardiography in Tako-Tsubo cardiomyopathy.

METHODS:

We prospectively studied 63 consecutive women admitted for suspected acute coronary syndrome who underwent coronary arteriography, biplane left ventricular angiography and conventional and contrast echocardiography; 25 women had Tako-Tsubo cardiomyopathy (group 1), 25 women had proven coronary artery disease (group 2) and 13 women had no significant coronary lesion (group 3). Echocardiographic interpretation was performed by two observers: a physician trainee (observer 1) and an experienced investigator (observer 2).

RESULTS:

Left ventricular segments were assessed for wall motion abnormalities, which were present in 70 and 88% (observer 1) and in 91 and 99% (observer 2), using conventional and contrast echocardiography, respectively (P<0.0001). Accuracy for the diagnosis of Tako-Tsubo cardiomyopathy was improved significantly for both observers using contrast echocardiography: for observer 1, sensitivity was 56 and 88%, respectively, using conventional and contrast echocardiography (P=0.01), whereas for observer 2, sensitivity was 72 and 96%, respectively (P=0.04). Interobserver agreement was excellent using contrast agent (kappa=0.85 vs 0.34 using conventional echocardiography). The blinded review of left ventriculograms distinguished Tako-Tsubo cardiomyopathy from coronary artery disease correctly in 96% of cases.

CONCLUSIONS:

Contrast echocardiography could be used in routine practice to replace left ventricular angiography in Tako-Tsubo cardiomyopathy.

2010 Elsevier Masson SAS. All rights reserved.

PMID:
21074123
[PubMed - indexed for MEDLINE]
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