Wall motion disturbances in Tako Tsubo cardiomyopathy (TTCM) are often rapidly decreasing in days between diagnosis via ventriculography and CMR imaging. The purpose of this retrospective study was to illuminate the diagnostic performance of cardiac magnetic resonance imaging feature tracking in fading wall motion abnormalitites in TTCM.

We compared cardiac magnetic resonance imaging (CMR) and ventriculography of 41 consecutive patients with TTCM. TTCM-involved regions were defined as regions with wall motion disturbances in ventriculography. With a dedicated cardiovascular software (Circle CVI®, Calgary, Canada), left and right ventricular strain values from TTCM-involved and not involved region were analysed and recorded (Figure 1).

In the period between coronary angiography and CMR, the severity of wall motion abnormalities is regularly declining. Nevertheless, even in the presence of only mild wall motion disturbances, feature tracking parameters of the left ventricle could easily discriminated between TTCM-involved and non-involved segments (e.g.: Circumferential strain in TTCM-involved region: -14.0 ± 7.9 vs. TTCM-not-involed: -19.2 ± 4.4; p < 0.0001; Figure 2 and 3). Interestingly, right ventricular strain values did not differ between involved and non-involved segments (e.g. RV radial strain: p = 0.069).

CMR feature tracking is a powerful tool for detection of fading left ventricular wall motion abnormalities in TTCM. Further research in larger cohorts is needed to establish the time relation between diminution of wall motion disturbance and feature tracking parameters.

Dr. Tilman Emrich Junior Consultant Radiology University Medical Center Mainz [email protected]