Right ventricular involvement in Tako-Tsubo cardiomyopathy detected by 2D speckle tracking echocardiography

Background Tako-Tsubo cardiomyopathy (TTC) is characterized by transient stress induced transient left ventricular (LV) dysfunction. Right ventricular (RV) involvement may occur and is associated with bad outcome. Assessment of RV function may be difficult using echo. Velocity vector imaging (VVI) is a new echo technology that measures myocardial velocity and deformation using 2D speckle tracking. The aim of this study was to assess RV involvement in TTC by VVI. Methods We prospectively studied 80 pts divided in 3 groups: 30 pts with TTC (group 1), 30 pts with CAD defined as a documented LAD occlusion (group 2) and a control group (n = 20, group 3). Groups 2 and 3 were age and gender matched with group 1. RV function was assessed by RV angiography or MRI, allowing the calculation of RV ejection fraction (RVEF) and was considered as our gold standard. We systematically performed echocardiography, with the use of VVI technology, allowing to measure peak velocity (V), peak strain (S) and peak strain rate (SR) in basal, mid and apical RV free wall (FW) in apical 4-chamber view. RV systolic function was also assessed by the RV fractional area change (FAC) measured in apical 4-chamber view. Results Prevalence of RV involvement in TTC was 35% and NYHA class was significantly higher (p  Conclusion Our study suggests that VVI could be of interest for the assessment of RV involvement in TTC, allowing to individualize high-risk pts.