Correlation between endothelial dysfunction and myocardial damage in acute phase of Tako-Tsubo cardiomyopathy: brachial flow mediated dilation as a potential marker for assessment of patient with Tako-Tsubo

Carbonara, Roberta; Giardinelli, Francesco; Pepe, Martino; Luzzi, Giovanni; Panettieri, I.; Vulpis, V.; Bortone, Alessandro Santo; Ciccone, Marco Matteo

doi:10.1007/s00380-017-1062-8

Cited by 12 publications

(5 citation statements)

References 29 publications

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“…In the course of a TTS patient’s hospitalization researchers showed a significant increase of flow-mediated vasodilatation (FMD). The negative correlation between the FMD value and TnI concentrations at admission and the length of the hospitalization was also described [ 34 ]. A sudden decrease in FMD values at admission may probably be associated to a high concentration of circulating catecholamines, which impair endothelium function, contract vascular smooth muscles, and decrease their sensitivity to vasodilatory mediators, whereas an increase of FMD values at discharge may be caused by a gradual decrease of catecholamines concentration in the blood.…”

Section: Pathophysiologymentioning

confidence: 99%

Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Budnik

Piątkowski

Ochijewicz

et al. 2021

JPM

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Takotsubo syndrome (TTS) consists of transient dysfunction of the left and/or right ventricle in the absence of ruptured plaque; thrombus or vessel dissection. TTS may be divided into two categories. Primary TTS occurs when the cause of hospitalization is the symptoms resulting from damage to the myocardium usually preceded by emotional stress. Secondary TTS occurs in patients hospitalized for other medical; surgical; anesthetic; obstetric or psychiatric conditions who have activation of their sympathetic nervous system and catecholamines release- they develop TTS as a complication of their primary condition or its treatment. There are several hypotheses concerning the cause of the disease. They include decrease in estrogen levels; microcirculation dysfunction; endothelial dysfunction and the hypothesis based on the importance of the brain-heart axis. More and more researches concern the importance of genetic factors in the development of the disease.To date; no effective treatment or prevention of recurrent TTS has been found. Only when the pathophysiology of the disease is fully known; personalized treatment will be possible.

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Section: Pathophysiologymentioning

confidence: 99%

Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Budnik

Piątkowski

Ochijewicz

et al. 2021

JPM

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“…Similarly, in another study performed on a group of 72 patients in the acute phase of COVID-19 (37% admitted to the ICU), a significant association between the FMD and troponin I level was observed [ 140 ]. Additionally, in patients in the acute phase of takotsubo cardiomyopathy, a significant correlation was observed between the troponin I peak and FMD value ( r = −0.7645, p < 0.001) [ 141 ].…”

Section: Cardiac Troponin Serum Level and Subclinical Cardiovascular ...mentioning

confidence: 99%

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

Jakubiak

2024

JPM

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Cardiac troponin serum concentration is the primary marker used for the diagnosis of acute coronary syndrome. Moreover, the measurement of cardiac troponin concentration is important for risk stratification in patients with pulmonary embolism. The cardiac troponin level is also a general marker of myocardial damage, regardless of etiology. The purpose of this study is to conduct a literature review and present the most important information regarding the current state of knowledge on the cardiac troponin serum concentration in patients with chronic cardiovascular disease (CVD), as well as on the relationships between cardiac troponin serum concentration and features of subclinical cardiovascular dysfunction. According to research conducted to date, patients with CVDs, such as chronic coronary syndrome, chronic lower extremities’ ischemia, and cerebrovascular disease, are characterized by higher cardiac troponin concentrations than people without a CVD. Moreover, the literature data indicate that the concentration of cardiac troponin is correlated with markers of subclinical dysfunction of the cardiovascular system, such as the intima–media thickness, pulse wave velocity, ankle–brachial index, coronary artery calcium index (the Agatston score), and flow-mediated dilation. However, further research is needed in various patient subpopulations and in different clinical contexts.

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“…Another significant aspect in the pathogenesis of TTS is the link between sex hormones, ED and CMD [ 99 ]. There is increasing evidence that ED is a key aspect of TTS both during the acute and long-term phase [ 56 , 57 , 100 ]. The endothelium is the main determinant of vascular tone, through the production of vasodilatory and vasoconstrictive substances and its function can be influenced by sex hormones with either receptor-dependent or independent mechanisms, thanks to the direct expression of oestrogens receptors on human vascular endothelium and smooth muscle cells [ 101 , 102 ].…”

Section: Evidence Supporting the Role Of Cmd In Ttsmentioning

confidence: 99%

Impact of Coronary Microvascular Dysfunction in Takotsubo Syndrome: Cause, Consequence or Both?

Caglioni,

Mele,

Milzi

et al. 2024

Rev. Cardiovasc. Med.

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Takotsubo syndrome (TTS) is an acute cause of heart failure characterized by a reversible left ventricular (LV) impairment usually induced by a physical or emotional trigger. TTS is not always a benign disease since it is associated with a relatively higher risk of life-threatening complications, such as cardiogenic shock, ventricular arrhythmias, respiratory failure, cardiopulmonary resuscitation and death. Despite notable advancements in the management of patients with TTS, physiopathological mechanisms underlying transient LV dysfunction remain largely unknown. Since TTS carries similar prognostic implications than acute myocardial infarction, the identification of mechanisms and predictors of worse prognosis remain key to establish appropriate treatments. The greater prevalence of TTS among post-menopausal women and the activation of the neuro-cardiac axis triggered by physical or emotional stressors paved the way forward to several studies focused on coronary microcirculation and impaired blood flow as the main physiopathological mechanisms of TTS. However, whether microvascular dysfunction is the cause or a consequence of transient LV impairment remains still unsettled. This review provides an up-to-date summary of available evidence supporting the role of microvascular dysfunction in TTS pathogenesis, summarizing contemporary invasive and non-invasive diagnostic techniques for its assessment. We will also discuss novel techniques focused on microvascular dysfunction in TTS which may support clinicians for the implementation of tailored treatments.

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Correlation between endothelial dysfunction and myocardial damage in acute phase of Tako-Tsubo cardiomyopathy: brachial flow mediated dilation as a potential marker for assessment of patient with Tako-Tsubo

Cited by 12 publications

References 29 publications

Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Cardiac Troponin Serum Concentration Measurement Is Useful Not Only in the Diagnosis of Acute Cardiovascular Events

Impact of Coronary Microvascular Dysfunction in Takotsubo Syndrome: Cause, Consequence or Both?

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