The value of Native T1 in the differential diagnosis of Takotsubo syndrome and acute myocardial infarction caused by left anterior descending coronary artery obstruction
SU Yanping1, 4, LU Chenying1,LYU Lingchun2, ZHENG Shenfei1, WANG Junhe1, 4, CHEN Minjiang3, JI Jiansong1, 3.
1.Department of Radiology, Lishui Central Hospital, Lishui 323000, China; 2.Department of Cadiology, Lishui Central Hospital,Lishui 323000, China; 3.Key Laboratory of Imaging Diagnosis and Minimally Invasive Research, Lishui Central Hospital, Lishui 323000, China; 4.The First School of Medicine, School of Information and Engineering,Wenzhou Medical University, Wenzhou 325035, China
SU Yanping,LU Chenying,LYU Lingchun, et al. The value of Native T1 in the differential diagnosis of Takotsubo syndrome and acute myocardial infarction caused by left anterior descending coronary artery obstruction[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(9): 697-704.
Abstract：Objective: To investigate the differential diagnostic value of cardiac magnetic resonance (CMR) Native T1 in Takotsubo syndrome (TTS) and acute myocardial infarction with left anterior descending coronary artery obstruction (AMI-LAD). Methods: 13 patients with TTS and 26 patients with AMI-LAD in Lishui Central Hospital from January 2018 to February 2022 were collected, who underwent 3.0 T CMR including Cine, T2STIR, T1 mapping, T2 mapping and late gadolinium enhancement (LGE) sequences. General data and serum biomarkers like CTNI, MYO, CK, CKMB, ALT, AST, CRP, LDH, BNP, and left ventricle function parameters like EF, EDV, ESV, SV, HR, CO, CI, and myocardial strains like GSR, GSC, GSL, and Native T1, ECV, and Native T2 of the two groups were compared. Univariate and multivariate Logistic regression analysis were used to screen independent risk factors and conduct modeling analysis. Results: TTS tends to occur in women, and tends to have lower BMI, CTNI, CKMB, but higher BNP, CRP, CK, and LDH. The left ventricle and edema segments in TTS have higher Native T1, T2, and lower ECV compared to AMI-LAD (P<0.05).Multivariate Logistic regression analysis suggested that BNP (OR=1.001, 95%CI=1.000-1.003, P=0.040) and Native T1 (OR=1.021, 95%CI=1.002-1.040, P=0.030) were the independent risk factors for TTS differentiating from AMI. BNP, T1native. ROC curve analysis showed combined models had AUCs of 0.852 (95%CI=0.702-0.945), 0.911(95%CI=0.776-0.978), and 0.920 (95%CI=0.787-0.983), respectively. They had a sensitivity of 84.62%, 84.62%, and 84.62%, and a specificity of 76.92%, 84.62%, and 96.15%, respectively. Conclusion:Native T1 is of important value in the differential diagnosis of TTS and AMI-LAD, and when combined with BNP, it can improve the diagnostic efficiency.
