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Abstract：
Background: Although takotsubo syndrome (TTS) is characterized by transient systolic dysfunction of the left ventricle (LV), the time course and mechanism of LV function recovery remain elusive. The aim of this study is to evaluate cardiac functional recovery in TTS via serial cardiac magnetic resonance feature tracking (CMR-FT). Methods: In this Japanese multicenter registry, patients with newly diagnosed TTS were prospectively enrolled. In patients who underwent serial cardiovascular magnetic resonance (CMR) imaging at 1 month and 1 year after the onset, CMR-FT was performed to determine the global circumferential strain (GCS), global radial strain (GRS) and global longitudinal strain (GLS). We compared LV ejection fraction, GCS, GRS and GLS at 1 month and 1 year after the onset of TTS. Results: Eighteen patients underwent CMR imaging in one month and one year after the onset in the present study. LV ejection fraction had already normalized at 1 month after the onset, with no significant difference between 1 month and 1 year (55.8 ± 9.2% vs. 58.9 ± 7.3%, p = 0.09). CMR-FT demonstrated significant improvement in GCS from 1 month to 1 year (-16.7 ± 3.4% vs. -18.5 ± 3.2%, p < 0.01), while there was no significant difference in GRS and GLS between 1 month and year (GRS: 59.6 ± 24.2% vs. 59.4 ± 17.3%, p = 0.95, GLS: -12.8 ± 5.9% vs. -13.8 ± 4.9%, p = 0.42). Conclusions: Serial CMR-FT analysis revealed delayed improvement of GCS compared to GRS and GLS despite of rapid recovery of LV ejection fraction. CMR-FT can detect subtle impairment of LV systolic function during the recovery process in patients with TTS.
摘要：
背景：尽管Takotsubo综合征（TTS）的特征是左心室（LV）的一过性收缩功能障碍，LV功能恢复的时程和机制仍然难以捉摸。本研究的目的是通过串联心脏磁共振特征跟踪（CMR-FT）评估TTS中的心脏功能恢复。方法：在这个日本多中心注册表中，新诊断的TTS患者被前瞻性纳入.在发病后1个月和1年接受系列心血管磁共振（CMR）成像的患者中，进行CMR-FT以确定整体周向应变(GCS)，全局径向应变(GRS)和全局纵向应变(GLS)。我们比较了左心室射血分数,GCS,TTS发病后1个月和1年的GRS和GLS。结果：本研究中有18例患者在发病后一个月和一年内接受了CMR成像。左心室射血分数在发病后1个月已经恢复正常，1个月和1年之间没有显着差异（55.8±9.2％vs.58.9±7.3％，p=0.09)。CMR-FT显示GCS从1个月到1年有显着改善（-16.7±3.4％vs.-18.5±3.2%，p<0.01),而1个月和1年之间的GRS和GLS没有显着差异（GRS：59.6±24.2％vs.59.4±17.3%,p=0.95，GLS：-12.8±5.9%vs.-13.8±4.9%，p=0.42）。结论：连续CMR-FT分析显示，尽管LV射血分数快速恢复，但与GRS和GLS相比，GCS的改善延迟。CMR-FT可以在TTS患者的恢复过程中检测到LV收缩功能的细微损害。
