PMID- 19389788
OWN - NLM
STAT- MEDLINE
DCOM- 20091008
LR  - 20151119
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 30
IP  - 13
DP  - 2009 Jul
TI  - Immunohistological basis of the late gadolinium enhancement phenomenon in 
      tako-tsubo cardiomyopathy.
PG  - 1635-42
LID - 10.1093/eurheartj/ehp140 [doi]
AB  - AIMS: Tako-tsubo cardiomyopathy is characterized by transient contractile 
      dysfunction after emotional or physical stress. Only few patients show late 
      gadolinium enhancement (LGE) in cardiovascular magnetic resonance imaging (MRI). 
      It was the purpose of this study to elucidate the histological basis of this 
      phenomenon. METHODS AND RESULTS: The study included 15 patients. Tako-tsubo 
      cardiomyopathy was diagnosed by coronary angiography and ventriculography. 
      Cardiac MRI was performed within 24 h of admission. Endomyocardial biopsies were 
      taken during the acute phase and after recovery. The content of fibrosis was 
      determined by immunohistochemical staining of collagen-1. In the acute phase, 
      cardiac MRI revealed LGE in five patients. This was completely reversed at 
      follow-up [14, inter-quartile range (IQR) 11-14.5 days]. All patients showed a 
      significant increase of collagen-1 compared with control tissue. Moreover, the 
      amount of collagen-1 was significantly higher in LGE positive patients (LGE 
      positive: 18.84, IQR 13.82-19.75 AU/microm(2); LGE negative: 7.57, IQR 5.41-9.19 
      AU/microm(2), P = 0.001). The presence of LGE was not associated with poorer left 
      ventricular function. CONCLUSION: The presence of LGE cannot rule out tako-tsubo 
      cardiomyopathy. Instead it defines a special subgroup of patients with a 
      disproportionate increase of extracellular matrix.
FAU - Rolf, Andreas
AU  - Rolf A
AD  - Department of Cardiology, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad 
      Nauheim, Germany. a.rolf@kerckhoff-klinik.de
FAU - Nef, Holger M
AU  - Nef HM
FAU - Mollmann, Helge
AU  - Mollmann H
FAU - Troidl, Christian
AU  - Troidl C
FAU - Voss, Sandra
AU  - Voss S
FAU - Conradi, Guido
AU  - Conradi G
FAU - Rixe, Johannes
AU  - Rixe J
FAU - Steiger, Holger
AU  - Steiger H
FAU - Beiring, Katharina
AU  - Beiring K
FAU - Hamm, Christian W
AU  - Hamm CW
FAU - Dill, Thorsten
AU  - Dill T
LA  - eng
PT  - Journal Article
DEP - 20090423
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Collagen Type I)
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
CIN - Eur Heart J. 2009 Dec;30(23):2948-9; author reply 2949. PMID: 19889650
MH  - Aged
MH  - Biopsy
MH  - Collagen Type I/metabolism
MH  - Contrast Media
MH  - Coronary Angiography
MH  - Endomyocardial Fibrosis/metabolism/pathology
MH  - Extracellular Matrix/pathology
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Takotsubo Cardiomyopathy/*diagnosis/metabolism/pathology
EDAT- 2009/04/25 09:00
MHDA- 2009/10/09 06:00
CRDT- 2009/04/25 09:00
PHST- 2009/04/25 09:00 [entrez]
PHST- 2009/04/25 09:00 [pubmed]
PHST- 2009/10/09 06:00 [medline]
AID - ehp140 [pii]
AID - 10.1093/eurheartj/ehp140 [doi]
PST - ppublish
SO  - Eur Heart J. 2009 Jul;30(13):1635-42. doi: 10.1093/eurheartj/ehp140. Epub 2009 
      Apr 23.