Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging

Ingo Eitel*, Florian Behrendt, Kathrin Schindler, Dietmar Kivelitz, Matthias Gutberlet, Gerhard Schuler, Holger Thiele

*Korrespondierende/r Autor/-in für diese Arbeit
182 Zitate (Scopus)

Abstract

Aims: The apical ballooning syndrome (ABS) is a new diagnostic entity which is increasingly recognized. Precise magnetic resonance imaging (MRI) data are not yet available and there is little evidence for the differential diagnosis of ABS assessed by MRI. Methods and results: Between January 2005 and January 2008, 6100 consecutive patients with diagnosis of acute coronary syndrome underwent left heart catheterization. In 59 patients (1.0%), coronary angiography revealed normal coronary arteries, but left ventriculography showed left ventricular dysfunction with apical ballooning. These 59 patients underwent cardiac MRI using a 1.5 T MRI scanner. In 13 patients (22.0%), MRI revealed diagnosis of myocardial infarction, in eight patients (13.6%) diagnosis of myocarditis. In all other 38 (64.4%) patients (36 female, age 73 ± 10 years) with suspected ABS, no delayed enhancement or signs of inflammation were detected. Follow-up MRI after 3 months showed a completely normalized left ventricular ejection in all patients with suspected ABS. Similarly, the end-diastolic volume and end-systolic volume improved at follow-up. Conclusion: Cardiac MRI allows differentiating ABS from other rare causes with unobstructed coronary vessels such as myocarditis and coronary emboli with spontaneous lysis. Therefore, cardiac MRI can add valuable information in all patients with suspected ABS for further differential diagnosis.

OriginalspracheEnglisch
ZeitschriftEuropean Heart Journal
Jahrgang29
Ausgabenummer21
Seiten (von - bis)2651-2659
Seitenumfang9
ISSN0195-668X
DOIs
PublikationsstatusVeröffentlicht - 11.2008

Strategische Forschungsbereiche und Zentren

  • Zentren: Universitäres Herzzentrum Lübeck (UHZL)

DFG-Fachsystematik

  • 2.22-12 Kardiologie, Angiologie

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