- 作者：Alberto R. De Caterina ; Antonio Maria Leone ; Leonarda Galiuto ; Eloisa Basile ; Elisa Fedele ; Lazzaro Paraggio ; Giovanni Luigi De Maria ; Italo Porto ; Giampaolo Niccoli ; Francesco Burzotta ; Carlo Trani ; Antonio G. Rebuzzi ; Filippo Crea
- 关键词：Tako-Tsubo syndrome ; Microvascular dysfunction ; Myocardial blush grade ; QuBE
- 刊名：International Journal of Cardiology
- 出版年：12 October, 2013
- 年：2013
- 卷：168
- 期：5
- 页码：4717-4722
- 全文大小：838 K
Objectives
To angiographically assess myocardial perfusion in patients with Tako-Tsubo syndrome (TTS) in comparison with control individuals and patients with ST-elevation myocardial infarction (STEMI).Background
Coronary microvascular dysfunction has been proposed as the pathophysiological mechanism underlying TTS.
Methods
We retrospectively selected consecutive TTS patients showing typical left ventricular (LV) apical dysfunction admitted to our Department in the period 2007-2011 (n = 25). We also enrolled an age and gender-matched control group showing normal coronary arteries (CTR, n = 25), patients with STEMI undergoing primary percutaneous intervention with myocardial reperfusion (SR, n = 25) or microvascular obstruction (SMVO, n = 25). TIMI flow, TIMI frame count (TFC) and both qualitative and quantitative myocardial blush grade in LV apex were assessed. Specifically, myocardial perfusion was quantitatively evaluated using 鈥楺uantitative Blush Evaluator鈥?(QuBE), an open source software previously validated in the setting of STEMI.
Results
In TTS, TIMI flow on the LAD was significantly lower and TFC significantly higher compared to CTR and SR (p = 0.008 for both), while it did not significantly differ compared to SMVO (p = 0.06). In TTS, MBG was significantly lower than that in CTR and SR (p = 0.001 for both), while it was significantly higher than that in SMVO (p < 0.001). In TTS, QuBE score was significantly lower than that in CTR and SR (p = 0.001 for both) and higher than in SMVO (p = 0.02).
Conclusions
Our data indicate that myocardial perfusion assessed during angiography is more impaired in patients with TTS than in patients with STEMI exhibiting myocardial reperfusion, while it is less impaired than in patients with STEMI exhibiting MVO.