Beyond apical ballooning: computational modelling reveals morphological features of Takotsubo cardiomyopathy

Abstract

Takotsubo cardiomyopathy (TCM) is characterized by transient myocardial dysfunction, typically at the left ventricular (LV) apex. Its pathophysiology and recovery mechanisms remain unknown. We investigated LV morphology and deformation in n = 28 TCM patients. Patients with MRI within 5 days from admission (“early TCM”) showed reduced LVEF and higher ventricular volumes, but no differences in ECG, global strains or myocardial oedema. Statistical shape modelling described LV size (Mode 1), apical sphericity (Mode 2) and height (Mode 3). Significant differences in Mode 1 suggest that “early TCM” LV remodeling is mainly influenced by a change in ventricular size rather than apical sphericity.

Keywords:

• Takotsubo cardiomyopathy
• cardiac magnetic resonance
• statistical shape modelling
• computational modelling
• myocardial deformation

Disclosure statement

Dr. Bucciarelli-Ducci is a consultant for Circle Cardiovascular Imaging. The other authors do not have conflict of interest.

Additional information

Funding

The authors acknowledge support from the British Heart Foundation. CBD was in part funded by the NIHR Biomedical Research Centre at University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.