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

Comput Methods Biomech Biomed Engin. 2019 Nov;22(14):1103-1106. doi: 10.1080/10255842.2019.1632836. Epub 2019 Jul 3.

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; computational modelling; myocardial deformation; statistical shape modelling.

MeSH terms

  • Aged
  • Algorithms
  • Female
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Models, Cardiovascular*
  • Takotsubo Cardiomyopathy / diagnostic imaging*
  • Takotsubo Cardiomyopathy / pathology*

Grants and 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.