{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T01:25:11Z","timestamp":1783473911145,"version":"3.55.0"},"reference-count":3,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sawtooth cardiomyopathy (CMP) or \u2018Tiger heart\u2019 is a rare form of CMP of which only several cases have been described in literature. Hereby, we present two cases with this phenotype using cardiovascular magnetic resonance (CMR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>The first case was asymptomatic and referred for family screening. Cardiovascular magnetic resonance showed non-dilated, non-hypertrophic left and right ventricles with good systolic function. Morphologic abnormalities were seen with multiple band-shaped muscular bridges from the septal to the inferior wall fitting \u2018sawtooth CMP\u2019. The second case had a recent stroke at young age and was referred for analysis regarding a possible source of cardiac embolism. Cardiovascular magnetic resonance showed a dilated left ventricle with a basal inferoseptal aneurysm and severely impaired systolic function. Late enhancement images showed transmural fibrosis apical inferior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These two cases of \u2018sawtooth CMP\u2019 illustrate a varying clinical picture from asymptomatic with normal ventricular function to dilated CMP with severely impaired systolic function. Reviewing current literature, we found several other case reports on sawtooth CMP. Sawtooth CMP was associated with various clinical sequelae including ventricular dysfunction, arrhythmias, and stroke. Non-invasive cardiovascular imaging was essential in their diagnostic work-up. The morphologic findings have been suggested to be different from established criteria to diagnose hypertrophic CMP or left ventricular non-compaction. The long-term prognostic implications are currently unknown.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaf461","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T11:49:33Z","timestamp":1758368973000},"source":"Crossref","is-referenced-by-count":1,"title":["MRI of the \u2018Tiger\u2019: a case series"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4403-4120","authenticated-orcid":false,"given":"Johannes M I H","family":"Gho","sequence":"first","affiliation":[{"name":"Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC , Dr. Molewaterplein 40, Rotterdam 3015 GD ,","place":["The Netherlands"]},{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Dr. Molewaterplein 40, Rotterdam 3015 GD ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Spaarne Gasthuis , Boerhaavelaan 22, Haarlem 2035 RC ,","place":["The Netherlands"]},{"name":"Department of Cardiology, Beatrixziekenhuis , Banneweg 57, Gorinchem 4204 AA ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter T G","family":"Bot","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Spaarne Gasthuis , Boerhaavelaan 22, Haarlem 2035 RC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Halbmeijer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Onze Lieve Vrouwe Gasthuis , Oosterpark 9, Amsterdam 1091 AC ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cihal","family":"G\u00fcrlek","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Adrz , \u2018s-Gravenpolderseweg 114, Goes 4462 RA ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3315-2006","authenticated-orcid":false,"given":"Alexander","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thorax Center, Cardiovascular Institute, Erasmus MC , Dr. Molewaterplein 40, Rotterdam 3015 GD ,","place":["The Netherlands"]},{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC , Dr. Molewaterplein 40, Rotterdam 3015 GD ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"2025110311544567800_ytaf461-B1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/1532-429X-11-54","article-title":"Saw-tooth cardiomyopathy","volume":"11","author":"Davlouros","year":"2009","journal-title":"J Cardiovasc Magn Reson"},{"key":"2025110311544567800_ytaf461-B2","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.jaccas.2020.05.072","article-title":"Saw-tooth cardiomyopathy: clinical presentation and genetic analysis","volume":"2","author":"Proukhnitzky","year":"2020","journal-title":"JACC Case Rep"},{"key":"2025110311544567800_ytaf461-B3","first-page":"301","article-title":"ROD2 domain filamin C missense mutations exhibit a distinctive cardiac phenotype with restrictive\/hypertrophic cardiomyopathy and saw-tooth myocardium","volume":"76","author":"Bermudez-Jimenez","year":"2023","journal-title":"Rev Esp Cardiol (Engl Ed)"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytaf461\/64356331\/ytaf461.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/11\/ytaf461\/64356331\/ytaf461.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/9\/11\/ytaf461\/64356331\/ytaf461.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T16:54:53Z","timestamp":1762188893000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytaf461\/8262576"}},"subtitle":[],"editor":[{"given":"Annagrazia","family":"Cecere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Soren","family":"Skott-Schmiegelow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Joon Heng","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Giorgia","family":"Benzoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":3,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,10,31]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaf461","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,9,23]]},"article-number":"ytaf461"}}