Emotional Stress-Induced 'Ampulla Cardiomyopathy' - Discrepancy Between the Metabolic and Sympathetic Innervation Imaging Performed During the Recovery Course -

• OWA Mafumi

  Third Department of Internal Medicine, Shinshu University School of Medicine

• AIZAWA Kazunori

  Third Department of Internal Medicine, Shinshu University School of Medicine

• URASAWA Nobuyuki

  Third Department of Internal Medicine, Shinshu University School of Medicine

• ICHINOSE Hiroyuki

  Third Department of Internal Medicine, Shinshu University School of Medicine

• YAMAMOTO Kazuya

  Third Department of Internal Medicine, Shinshu University School of Medicine

• KARASAWA Koji

  Third Department of Internal Medicine, Shinshu University School of Medicine

• KAGOSHIMA Mitsuru

  Third Department of Internal Medicine, Shinshu University School of Medicine

• KOYAMA Jun

  Third Department of Internal Medicine, Shinshu University School of Medicine

• IKEDA Shu-ichi

  Third Department of Internal Medicine, Shinshu University School of Medicine

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 (^<201>Tl), respectively. In the acute phase, MIBG and BMIPP imaging showed an uptake defect in the apical region, whereas ^<201>Tl 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 ^<201>Tl. These observations suggest that the primary cause of ampulla cardiomyopathy is related to a disturbance of the cardiac sympathetic innervation.

Journal

• Jpn Circ J

  Jpn Circ J 65 (4), 349-352, 2001-03-20

  Japanese Circulation Society

Keywords

• I-123-β-metyl-iodophenyl pentadecanoic acid (BMIPP)
• Ampulla cardiomyopathy
• I-123-metaiodobenzyl-guanidine (MIBG)
• Takotsubo cardiomyopathy

Details

• CRID: 1573668926986747520
• NII Article ID: 110002567051
• NII Book ID: AA00690731
• ISSN: 00471828
• Web Site: https://search.jamas.or.jp/link/ui/2002035562
• Text Lang: en
• Data Source:
  • CiNii Articles