technetium-tc-99m-tetrofosmin and Takotsubo-Cardiomyopathy

Topics: Humans; Myocardial Perfusion Imaging; Organophosphorus Compounds; Organotechnetium Compounds; Radiopharmaceuticals; Takotsubo Cardiomyopathy; Tomography, Emission-Computed, Single-Photon

Topics: Blood Glucose; Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; Chest Pain; Coronary Angiography; Diagnosis, Differential; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Image Processing, Computer-Assisted; Middle Aged; Myocardial Stunning; Organophosphorus Compounds; Organotechnetium Compounds; Positron-Emission Tomography; Takotsubo Cardiomyopathy; Tomography, X-Ray Computed

To gain more insight into the involvement of inflammatory response and neurohumoral activation in Takotsubo cardiomyopathy (TTC), we investigated C-reactive protein (CRP), leukocytes, plasma catecholamines levels, iodine 123 meta-iodobenzylguanidine (123I-mIBG) myocardial uptake, myocardial perfusion (thallium 201 [201Tl] or technetium [Tc] 99m-tetrofosmin myocardial single photon emission computed tomography [SPECT]), and metabolism (fluorine 18-fluorodeoxyglucose positron emission tomography).. Inflammatory status and brain natriuretic peptide (BNP) levels in 17 patients with TTC were compared with 14 age-matched patients. In TTC, elevated levels of CRP were evidenced on admission, reaching a peak in the following days (P < .01). CRP levels were correlated to baseline left ventricular ejection fraction (LVEF) and BNP levels (P < .05). Leukocytes were correlated to BNP and noradrenaline levels. Myocardial 123I-mIBG SPECT showed a reduced activity in the midventricle and apex corresponding to 35% +/- 23% of the total myocardial mass, partially reversible at follow-up. An identical pattern was retrieved when assessing myocardial glucose metabolism. At rest, no relevant abnormalities of myocardial perfusion could be evidenced at the subacute phase.. Inflammatory status in TTC was related to LVEF impairment and to the extent of neurohormonal activation. The hypothesis of a catecholamine-induced myocardial "stunning" is emphasized by the evidence of a reduced 123I-mIBG myocardial activity, impairment of myocardial glucose metabolism, and wall motion kinetic after the same temporospatial distribution.

Topics: 3-Iodobenzylguanidine; Aged; C-Reactive Protein; Case-Control Studies; Catecholamines; Coronary Circulation; Female; Fluorodeoxyglucose F18; Glucose; Humans; Leukocyte Count; Male; Myocardium; Natriuretic Peptide, Brain; Norepinephrine; Organophosphorus Compounds; Organotechnetium Compounds; Positron-Emission Tomography; Radiopharmaceuticals; Takotsubo Cardiomyopathy; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon; Troponin I