Aim To evaluate the endothelial function using an Endo-PAT2000 instrument before and after mental stress tests in patients with Tacotsubo syndrome (TS) during acute and long-term periods and to compare the obtained results with laboratory markers of endothelial dysfunction (ED).Material and methods This study included 45 patients with TS (mean age, 63.5±13.7 years) and 40 healthy volunteers (control group, CG). All patients of the main group during the acute period (first 7–14 days) and long-term period (at 1 and 2 years), as well as CG subjects, underwent evaluation of the endothelial function with an Endo-PAT 2000 instrument, and the reactive hyperemia index (RHI) was determined before and after mental stress tests. Also, concentrations of endothelin 1 (ET-1) and numbers of circulating endothelial cells (CEC) were measured after a two-year follow-up of TS patients.Results During the acute period of disease, all TS patients (n=45) had ED: RHI was below the threshold level of 1.67; furthermore, 42 (93.3 %) patients retained a lower RHI following mental stress. At one year (n=40), 16 (40%) patients showed ED at rest along with a significantly increased mean RHI. Mental stress produced at one year was associated with ED in 28 (70 %) TS patients. At two years (n=44), resting RHI was lower than normal in 19 (43.2 %) patients. Mental stress tests performed at two years were associated with ED in 29 (65.9 %) patients (RHI ≤1.67). Only 10% of CG subjects had a lower-than-normal RHI, which was significantly less than in the main group of TS patients during the acute and long-term periods (p<0.05). Mean values of laboratory markers for ED also were significantly different between TS patients during the long-term period of disease (n=41) and CG subjects (n=40; p<0.01).Conclusion During acute and long-term periods of disease, most of TS patients had impaired vascular reactivity both at rest and during mental stress. The laboratory markers of ED, ET-1 and CEC can be used in clinical practice for evaluation of the risk for TS.
The article describes a case report of acute myocardial injury developed against the background of systemic inflammatory response in a patient with chronic tonsillitis exacerbation, who had no signs of coronary artery atherosclerosis and pathological changes according to cardiac magnetic resonance imaging. The differential diagnosis and discussion of the problem of acute non-ischemic myocardial injury are presented.
The article describes the clinical case of takotsubo syndrome in female, who has also echocardiographic picture of a left ventricular noncompaction cardiomyopathy. According to the result of magnetic resonance imaging, the diagnosis of noncompaction cardiomyopathy was not confirmed, left ventricular hypertrabeculation was revealed. There are single descriptions of the combination of takotsubo syndrome and left ventricular hypertrabeculation, the pathogenetic relationship of these conditions has not yet been established.
Takotsubo syndrome (TS) is an acute reversible left ventricular myocardial dysfunction caused by an emotional or physical trigger. In the perioperative period, TS is in some cases induced by various psychological factors, such as stress before/after surgery, and non-psychological factors, such as drug administration. This article describes the clinical observation of takotsubo syndrome that developed in the early postoperative period of rhinoplasty
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