Inflammation in takotsubo cardiomyopathy: Insights from cardiovascular magnetic resonance imaging

Ingo Eitel*, Christian Lücke, Matthias Grothoff, Mahdi Sareban, Gerhard Schuler, Holger Thiele, Matthias Gutberlet

*Corresponding author for this work
114 Citations (Scopus)


Objective: Takotsubo cardiomyopathy (TTC) is an increasingly recognised acute cardiac syndrome, whose underlying pathophysiological mechanisms remain unknown. Inflammation might play a role as this has been shown in endomyocardial biopsies. The aim of this study was to assess inflammatory parameters in patients with TTC using a comprehensive cardiovascular magnetic resonance imaging (CMR) approach. Methods: Thirty-seven patients with the suspected diagnosis of TTC underwent CMR. T2-weighted imaging to calculate the oedema ratio, T1-weighted imaging before and after contrast agent administration to calculate the global relative enhancement (gRE), and late gadolinium enhancement (LGE) imaging were performed. Results: In 11 patients CMR revealed the diagnosis of myocardial infarction (n=7; 19%) or myocarditis (n=4; 11%) with typical patterns of LGE. In all other patients (n=26; 70%), no LGE was detected consistent with the diagnosis of TTC. Of these, in 16 patients (62%) both inflammatory markers (oedema ratio and gRE) were elevated with concomitant pericardial effusion, indicating acute inflammation. Follow-up CMR after 3 months showed complete normalisation of left ventricular function and inflammatory parameters in the absence of LGE and pericardial effusion. Conclusion: This CMR study provides further insights into the pathophysiological mechanisms in TTC, supporting the contribution of an inflammatory process in the acute setting.

Original languageEnglish
JournalEuropean Radiology
Issue number2
Pages (from-to)422-431
Number of pages10
Publication statusPublished - 02.2010

Research Areas and Centers

  • Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

  • 205-12 Cardiology, Angiology

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