Cardiac MRI studies of transient left ventricular apical ballooning syndrome (takotsubo cardiomyopathy): A systematic review

International Journal of Cardiology 135 (2009) 146 – 149

Cardiac MRI studies of transient left ventricular apical ballooning syndrome (takotsubo cardiomyopathy): A systematic review

Guillaume Leurent a , b , c , d ,⁎, Antoine Larralde e , Dominique Boulmier a , b , c , d , Claire Fougerou f , Bernard Langella e , Romain Ollivier a , b , c , d , Marc Bedossa a , b , c , d , Hervé Le Breton a , b , c , d

a INSERM, U642, Rennes, F-35000, France b Université de Rennes 1, LTSI, Rennes, F-35000, France c CHU Rennes, Service de cardiologie et maladies vasculaires, Rennes, F-35000, France d INSERM, CIC-IT 804, CHU de Rennes, F-35000, France e Département d'imagerie médicale, CHU de Rennes, F-35000, France f Centre d'Investigation Clinique, INSERM 0203, F-35000, France

Abstract

Background: Since its first description in 1991, many cases of transient left ventricular apical ballooning syndrome (TLVABS) have been

described, but the use of cardiac MRI in this condition is much more recent.

Methods and results: We performed a systematic review of the present literature in the MEDLINE and EMBASE databases for relevant case

series of TLVABS (≥ 5 reported original cases, MRI analysis in the acute phase) and summarized the main results in a narrative synthesis.

Only 8 studies met the eligible criteria, counting 176 patients (women: 95%; age: 68, stress trigger: 80%). MRI assessed an improvement of

mean left ventricular ejection fraction from 39 (in the acute phase) to 64% (in the recovery phase). A right ventricular dysfunction was

reported in 38%, a myocardial oedema in 81% and an apical thrombus in 5%.

Conclusions: Although cardiac MRI is a very useful and inescapable tool in the management of TLVABS, there is no large published study

concerning this topic. A systematic and multicentric register of TLVABS studied by cardiac MRI is necessary.

Keywords: Cardiac MRI; Transient left ventricular apical ballooning syndrome; Takotsubo cardiomyopathy; Left ventricular dysfunction

© 2009 Elsevier Ireland Ltd. All rights reserved.

Received 11 February 2009; accepted 2 March 2009

Available online 28 April 2009