Myocardial perfusion and fatty acid metabolism in patients with tako-tsubo-like left ventricular dysfunction
Satoshi Kurisu, MD*,*,
Ichiro Inoue, MD*,
Takuji Kawagoe, MD*,
Masaharu Ishihara, MD*,
Yuji Shimatani, MD*,
Kenji Nishioka, MD*,
Takashi Umemura, MD*,
Suji Nakamura, MD*,
Masashi Yoshida, MD* and
Hikaru Sato, MD*
* Division of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
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Figure 1 Time course of myocardial perfusion and fatty acid metabolism assessed by serial rest 201Tl and 123I-BMIPP dual-isotope myocardial single-photon emission computed tomography performed at 5 ± 3 days (acute phase), 15 ± 3 days (subacute phase), and 29 ± 6 days (follow-up) after onset. Myocardial fatty acid metabolism was more severely impaired than myocardial perfusion during the early phase and improved gradually during follow-up.
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Figure 2 Time course of left ventriculograms (top panel) and single-photon emission computed tomography (SPECT) images (bottom panel) in a patient with tako-tsubo-like left ventricular (LV) dysfunction. Tako-tsubo-like LV dysfunction complicated by a pressure gradient of 70 mm Hg through the LV outflow tract and moderate mitral regurgitation was dramatically resolved after 14 days. In this case, early SPECT revealed similarly reduced uptake between 201Tl and 123I-BMIPP at eight days. Although reduced uptake of 201Tl improved at 15 days, reduced uptake of 123I-BMIPP was sustained even after resolution of tako-tsubo-like LV dysfunction. ED = end-diastole; ES = end-systole; LCA = left coronary artery.
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Figure 3 Immediately after onset, the thrombolysis in myocardial infarction (timi) frame count was 63 ± 24 in the left anterior descending coronary artery (lad), 42 ± 15 in the left circumflex artery (lcx), and 48 ± 16 in the right coronary artery (rca). at follow-up, the timi frame count significantly decreased to 47 ± 13 in the lad, to 36 ± 10 in the lcx, and to 37 ± 8 in the rca. however, compared with control subjects, the timi frame count was significantly higher in all coronary arteries, even at follow-up. data are shown as the mean value (sd).
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