Emotional Stress-Induced `Ampulla Cardiomyopathy Discrepancy Between the Metabolic and Sympathetic Innervation Imaging Performed During the Recovery Course
Four patients had the clinical features of `ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal normokinesis, normal coronary angiogram, ST-segment elevation and subsequent giant T wave inversion, which mimicked acute coronary syndrome, the o...
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Published in | JAPANESE CIRCULATION JOURNAL Vol. 65; no. 4; pp. 349 - 352 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
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Kyoto
The Japanese Circulation Society
2001
Japanese Circulation Society |
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Abstract | Four patients had the clinical features of `ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal normokinesis, normal coronary angiogram, ST-segment elevation and subsequent giant T wave inversion, which mimicked acute coronary syndrome, the onset of which occurred shortly after extreme mental stress. Myocardial necrosis was minimal, although 2 patients showed elevated serum catecholamine levels in the acute phase. Each patient underwent serial cardiac radionuclide single-photon emission computed tomography of myocardial functional sympathetic innervation, fatty acid metabolism and perfusion using I-123-metaiodobenzyl-guanidine (MIBG), I-123-β-metyl-iodophenyl pentadecanoic acid (BMIPP) and thallium-201 (201Tl), respectively. In the acute phase, MIBG and BMIPP imaging showed an uptake defect in the apical region, whereas 201Tl uptake was mildly decreased. When assessed semi-quantitatively, the MIBG images had higher defect scores from the acute phase throughout the year of observation compared with BMIPP, and 201Tl. These observations suggest that the primary cause of ampulla cardiomyopathy is related to a disturbance of the cardiac sympathetic innervation. (Jpn Circ J 2001; 65: 349 - 352) |
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AbstractList | Four patients had the clinical features of `ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal normokinesis, normal coronary angiogram, ST-segment elevation and subsequent giant T wave inversion, which mimicked acute coronary syndrome, the onset of which occurred shortly after extreme mental stress. Myocardial necrosis was minimal, although 2 patients showed elevated serum catecholamine levels in the acute phase. Each patient underwent serial cardiac radionuclide single-photon emission computed tomography of myocardial functional sympathetic innervation, fatty acid metabolism and perfusion using I-123-metaiodobenzyl-guanidine (MIBG), I-123-β-metyl-iodophenyl pentadecanoic acid (BMIPP) and thallium-201 (201Tl), respectively. In the acute phase, MIBG and BMIPP imaging showed an uptake defect in the apical region, whereas 201Tl uptake was mildly decreased. When assessed semi-quantitatively, the MIBG images had higher defect scores from the acute phase throughout the year of observation compared with BMIPP, and 201Tl. These observations suggest that the primary cause of ampulla cardiomyopathy is related to a disturbance of the cardiac sympathetic innervation. (Jpn Circ J 2001; 65: 349 - 352) Four patients had the clinical features of 'ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal normokinesis, normal coronary angiogram, ST-segment elevation and subsequent giant T wave inversion, which mimicked acute coronary syndrome, the onset of which occurred shortly after extreme mental stress. Myocardial necrosis was minimal, although 2 patients showed elevated serum catecholamine levels in the acute phase. Each patient underwent serial cardiac radionuclide single-photon emission computed tomography of myocardial functional sympathetic innervation, fatty acid metabolism and perfusion using I-123-metaiodobenzyl-guanidine (MIBG), I-123-beta-metyl-iodophenyl pentadecanoic acid (BMIPP) and thallium-201 (201Tl), respectively. In the acute phase, MIBG and BMIPP imaging showed an uptake defect in the apical region, whereas 201Tl uptake was mildly decreased. When assessed semi-quantitatively, the MIBG images had higher defect scores from the acute phase throughout the year of observation compared with BMIPP, and 201Tl. These observations suggest that the primary cause of ampulla cardiomyopathy is related to a disturbance of the cardiac sympathetic innervation. |
Author | Owa, Mafumi Yamamoto, Kazuya Koyama, Jun Aizawa, Kazunori Ichinose, Hiroyuki Karasawa, Koji Kagoshima, Mitsuru Ikeda, Shu-ichi Urasawa, Nobuyuki |
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Cites_doi | 10.1253/jcj.59.236 10.1253/jcj.64.156 10.1161/01.CIR.98.13.1349 10.1016/0735-1097(94)90008-6 10.1016/S0002-9149(96)00540-1 10.1253/jcj.60.809 10.1161/01.CIR.79.3.634 10.1161/01.CIR.92.8.2183 10.1016/S0022-5223(19)35666-1 10.1378/chest.103.4.1274 |
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Keywords | Radionuclide study Human Cardiomyopathy Clinical form Cardiovascular disease Emotion emotionality Sympathetic nervous system Myocardial disease Photon Stress Case study Heart disease Emission tomography |
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Snippet | Four patients had the clinical features of `ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal... Four patients had the clinical features of 'ampulla cardiomyopathy', consisting of acute-onset transient left ventricular apical akinesis with basal... |
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SubjectTerms | 3-Iodobenzylguanidine - pharmacokinetics Aged Ampulla cardiomyopathy Autonomic Nervous System Diseases - etiology Autonomic Nervous System Diseases - physiopathology Biological and medical sciences Cardiology. Vascular system Catecholamines - blood Chest Pain - etiology Disasters Emotions Family Relations Fatty Acids - metabolism Female Heart Heart - diagnostic imaging Heart Conduction System - physiopathology Humans I-123-b-metyl-iodophenyl pentadecanoic acid (BMIPP) I-123-metaiodobenzyl-guanidine (MIBG) Iodine Radioisotopes Iodobenzenes Medical sciences Middle Aged Myocarditis. Cardiomyopathies Myocardium - metabolism Nerve Endings - diagnostic imaging Radiopharmaceuticals - pharmacokinetics Stress, Psychological - complications Stress, Psychological - physiopathology Takotsubo cardiomyopathy Thallium Radioisotopes Tomography, Emission-Computed, Single-Photon Ventricular Dysfunction, Left - blood Ventricular Dysfunction, Left - diagnostic imaging Ventricular Dysfunction, Left - etiology Ventricular Dysfunction, Left - pathology |
Subtitle | Discrepancy Between the Metabolic and Sympathetic Innervation Imaging Performed During the Recovery Course |
Title | Emotional Stress-Induced `Ampulla Cardiomyopathy |
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