A Heartbreaking Renal Transplantation: Is Norepinephrine the Culprit to Blame?

Vailas, Michail; Vernadakis, Spiridon; Kakavia, Kyriaki; Paizis, Ioannis; Bokos, John; Boletis, John; Zavos, G.

doi:10.1016/j.transproceed.2016.05.014

Cited by 11 publications

(8 citation statements)

References 14 publications

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“…Because of the extreme similarities between two reported pheochromocytoma‐induced TS cases, one case which was reported later was excluded . In total, 156 cases reports (107 cases with PPGL‐induced TS, 42 cases epinephrine‐induced TS, and 7 cases norepinephrine‐induced TS) constitute the patient cohort for the meta‐analysis. Among the cases included were two non‐English case reports (one case in Swedish and one in German) where enough information could be obtained.…”

Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

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Innumerable physical stress factors including externally administered catecholamines, and pheochromocytomas and paragangliomas (PPGLs) have been reported to trigger Takotsubo syndrome (TS). A systematic search of PubMed/MEDLINE identified 156 patients with catecholamine-induced TS up to December 2017. Data were compared within the catecholamine-induced TS cohort, but some comparisons were also done to a previously published large all-TS cohort (n = 1750). The mean age was 46.4 ± 16.4 years (72.3% women). The clinical presentation was dramatic with high complication rates in (68.2%, n = 103; multiple complications 34.6%, n = 54). The most common TS ballooning pattern was apical or mid-apical (45.2%, n = 69), followed by basal pattern (28.8%, n = 45), global pattern (16.0%, n = 25), midventricular (8.3%, n = 13), focal (0.6%, n = 1), and unidentified pattern (1.9%, n = 3).There was an increase in the prevalence of apical sparing ballooning pattern compared to all-TS population (37.7% vs 18.3%, P < .00001). Higher complication rates were observed in TS with global ballooning pattern compared to apical ballooning pattern (23/25, 92% vs 38/65, 58.5%; P = .0022). Higher complication rates were observed in patients with age < 50 years than patients >50 years (73/92, 79.3% vs 29/56, 51.8%, P = 0.0009). Recurrence occurred exclusively in patients with PPGLinduced TS (18/107 patients, 16.8%). PPGL-induced TS was characterized by more global ballooning's pattern (22/104, 21.2% vs 3/49, 6.1%, P = 0.02), and lower left ventricular ejection fraction (25.54 ± 11.3 vs 31.82 ± 9.93, P = 0.0072) compared to exogenous catecholamine-induced TS. In conclusion, catecholamine-induced TS was characterized by a dramatic clinical presentation with extensive left ventricular dysfunction, and high complication rate. K E Y W O R D S broken heart syndrome, epinephrine, myocardial stunning, norepinephrine, paraganglioma, pheochromocytoma, Takotsubo

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Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

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“…[4] tacrolimus levels being 40.5 ng/mL, but in our case, tacrolimus levels were 6.4 ng/mL. In case of report given by Vailas et al .,[5] the potential role of exogenous administration of norepinephrine was thought as the causal agent as they had to use the same for intraoperative hypotension, but in our case surgery was uneventful.…”

mentioning

confidence: 51%

His heart broke posttransplant: A rare disease with good outcome

Mishra¹,

Prakash²,

Gera³

et al. 2019

Indian J Nephrol

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“…Thus, coronary vasospasm involvement is not considered by many scientists to be a causative factor for the development of TCM. 3,28,29 Special considerations in takotsubo cardiomyopathy cases after solid-organ transplant As far as the pathophysiology of TCM in transplant recipients is concerned, it is noteworthy that solidorgan transplant is a situation associated with a state of large exposure to catecholamines, posing a great risk to potential organ recipients in developing cardiac complications postoperatively. In addition, coronary vasospasm, as opposed to the current knowledge, has been linked to the development of TCM in a case of a 64-year-old man who underwent OLT due to end-stage liver disease secondary to nonalcoholic steatohepatitis.…”

Section: General Aspects Of Takotsubo Cardiomyopathymentioning

confidence: 99%

Untitled

2017

Exp Clin Transplant

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Objectives: Takotsubo cardiomyopathy, also known as "broken heart syndrome," "apical ballooning syndrome," and "stress-induced cardiomyopathy," was first des cribed in Japanese patients in 1990 by Sato and colleagues. Takotsubo cardiomyopathy is an increasingly recognized syndrome characterized by transient and reversible systolic dysfunction of the apical and middle segments of the left ventricle. This syndrome resembles acute myocardial infarction in the absence of evident coronary artery occlusion. Although the precise pathophysiology of takotsubo cardiomyopathy is still unknown, it seems that it is associated with excessive sympathetic stimulation, microvascular dysfunction, coronary artery vasospasm, and abnormal myocardial tissue metabolism. Materials and Methods: Herein, we sought to recognize and summarize the available literature data on Takotsubo cardiomyopathy regarding solid-organ transplant, in an attempt to provide the demographic and morphologic functional characteristics of patients with Takotsubo cardiomyopathy and related clinical implications. Results and Conclusions: Transplant surgeons should maintain a high index of clinical suspicion and never underestimate takotsubo cardiomyopathy as a potential cause of heart failure following solid-organ transplant.

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A Heartbreaking Renal Transplantation: Is Norepinephrine the Culprit to Blame?

Cited by 11 publications

References 14 publications

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

His heart broke posttransplant: A rare disease with good outcome

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