Abstract
A 57-year-old female presented to us with takotsubo cardiomyopathy. Echocardiogram
revealed systolic anterior movement of the mitral valve (SAM) and severe mitral regurgitation
(MR) with left ventricular (LV) dysfunction. After intensive medical treatment, SAM
and MR almost disappeared along with the restoration of LV wall motion abnormality.
We quantitatively analyzed three-dimensional mitral complex geometry at the acute
phase and the recovery phase. At the initial examination when the transient SAM was
observed, annulus diameters and area were significantly smaller, compared with the
recovery phase. Excessive systolic movement of the annulus along with hyperdynamic
LV basal wall may contribute to the transient SAM with severe MR.
Learning objective
Recent studies have suggested systolic anterior movement of the mitral valve (SAM)
causes acute mitral regurgitation in patients with takotsubo cardiomyopathy. However,
the mechanism of transient SAM in Takotsubo cardiomyopathy remains unclear. This is
the first report that assessed the unique geometric mechanisms of transient SAM in
Takotsubo cardiomyopathy.
Keywords
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References
- Left ventricular apical ballooning syndrome as a novel cause of acute mitral regurgitation.J Am Coll Cardiol. 2007; 50: 647-649
- Incidence and clinical significance of mitral regurgitation in Takotsubo cardiomyopathy.Clin Res Cardiol. 2010; 99: 93-98
- Clinical features and outcomes of takotsubo (stress) cardiomyopathy.N Engl J Med. 2015; 373: 929-938
- Transient apical ballooning syndrome—clinical characteristics, ballooning pattern, and long-term follow-up in a Swiss population.Int J Cardiol. 2009; 135: 370-375
- Mechanisms of acute mitral regurgitation in patients with takotsubo cardiomyopathy: an echocardiographic study.Circ Cardiovasc Imaging. 2011; 4: 392-398
- Dynamic change of mitral apparatus as potential cause of left ventricular outflow tract obstruction in hypertrophic cardiomyopathy.Eur J Echocardiogr. 2011; 12: 19-25
Article info
Publication history
Published online: June 04, 2022
Accepted:
April 22,
2022
Received in revised form:
March 23,
2022
Received:
May 26,
2021
Identification
Copyright
© 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved. All rights reserved.
