Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Budnik, Monika; Piątkowski, Radosław; Ochijewicz, Dorota; Zaleska, Martyna; Grabowski, Marcin; Opolski, Grzegorz

doi:10.3390/jpm11090879

Cited by 4 publications

(3 citation statements)

References 59 publications

(67 reference statements)

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“…Primary cases are admitted to the hospital due to symptoms related to heart disease. On the other hand, secondary TTS cases are admitted to the hospital due to other disease and these patients develop TTS within the hospital stay [ 27 ]. Data have shown that both categories are associated with different outcomes.…”

Section: Discussionmentioning

confidence: 99%

A Case Series of Concomitant Cardiac Electrical Disease among Takotsubo Syndrome Patients and Literature Review

El‐Battrawy

Erath

Vámos

et al. 2022

JCDD

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The pathophysiology of Takotsubo Syndrome (TTS) is not completely understood and the trigger of sudden cardiac death (SCD) in TTS is not clear either. We therefore sought to find an association between TTS and primary electrical diseases. A total of 148 TTS patients were analyzed between 2003 and 2017 in a bi-centric manner. Additionally, a literature review was performed. The patients were included in an ongoing retrospective cohort database. The coexistence of TTS and primary electrical diseases was confirmed in five cases as the following: catecholaminergic polymorphic ventricular tachycardia (CPVT, 18-year-old female) (n = 1), LQTS 1 (72-year-old female and 65-year-old female) (n = 2), LQTS 2 (17-year-old female) (n = 1), and LQTS in the absence of mutations (22-year-old female). Four patients suffered from malignant tachyarrhythmia and recurrent syncope after TTS. Except for the CPVT patient and one LQTS 1 patient, all other cases underwent subcutaneous ICD implantation. An event recorder of the CPVT patient after starting beta-blocker did not detect arrhythmias. The diagnosis of primary electrical disease was in 80% of cases unmasked on a TTS event. This diagnosis triggered a family clinical and genetic screening confirming the diagnosis of primary electrical disease. A subsequent literature review identified five cases as the following: a congenital atrioventricular block (n = 1), a Jervell and Lange-Nielsen Syndrome (n = 1), and a family LQTS in the absence of a mutation (n = 2), LQTS 2 (n = 1). A primary electrical disease should be suspected in young and old TTS patients with a family history of sudden cardiac death. In suspected cases, e.g., ongoing QT interval prolongation, despite recovery of left ventricular ejection fraction a family screening is recommended.

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Section: Discussionmentioning

confidence: 99%

A Case Series of Concomitant Cardiac Electrical Disease among Takotsubo Syndrome Patients and Literature Review

El‐Battrawy

Erath

Vámos

et al. 2022

JCDD

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“…Finalmente, en un tercer momento se demuestra FA con respuesta ventricular alta pudiendo ser un evento incidental, ya que la paciente reunió condiciones para desarrollarla; formar parte del síndrome cerebro-corazón; ser secundaria al infarto de miocardio 18 o tratarse de FA preexistente, las cuales se detectan con mayor frecuencia después de un ACV; esto genera un debate para demostrar que los episodios de FA se desencadenan por el síndrome cerebro-corazón o son la causa del ictus inicial 1 , 2 . Estos tres eventos (ACV isquémico, síndrome de Takotsubo y FA) forman parte del síndrome cerebro-corazón que ocurre con mayor frecuencia dentro de los primeros tres días del evento cerebrovascular, estando asociado a la edad avanzada, prevalencia de comorbilidades cardíacas y factores de riesgo cardiovascular 1 , 2 , lo cual explica el daño cardíaco por la interacción a través del eje nerviosos cerebro-corazón causando inflamación, desregulación autónoma central, liberación de catecolaminas, cambios estructurales del miocardio y anomalías de la pared vascular 2 , 19 .…”

Section: Discussionunclassified

Síndrome de Takotsubo: complicación cardiovascular del accidente cerebrovascular

Abanto

Palomino

Hernández

et al. 2022

Arch Peru Cardiol Cir Cardiovasc

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Mujer adulta mayor, 82 años, Katz A, con antecedente de diabetes mellitus tipo 2 e hipertensión arterial; ingresa por accidente cerebrovascular isquémico que se complica con síndrome de Takotsubo con posterior reingreso por fibrilación auricular tras el alta médica. Estos tres eventos clínicos tienen criterios para integrarse como un síndrome cerebro-corazón, el cual es una condición de alto riesgo para mortalidad.

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“…Moreover, high levels of circulating catecholamines reduce receptivity to vasodilatory mediators. This may be the cause of a sudden drop in flow-mediated vasodilatation at admission, whereas a gradual drop in catecholamine levels in the blood may result in an increase in flow-mediated vasodilatation values at discharge [ 33 ]. Furthermore, different grades of perfusion (TIMI) have been observed in angiographic studies [ 34 ].…”

Section: Pathophysiology Of Ttsmentioning

confidence: 99%

Takotsubo Syndrome: The Secret Crosstalk between Heart and Brain

Schino¹,

Bezzeccheri²,

Russo³

et al. 2023

Rev. Cardiovasc. Med.

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An acute, transient episode of left ventricular dysfunction characterizes Takotsubo syndrome. It represents about 2% of all cases of acute coronary syndrome (ACS), and occurs predominantly in postmenopausal women, generally following a significant physical or emotional stressor. It can be diagnosed based on clinical symptoms and the absence of coronary artery disease on angiography. Ventriculography remains the gold standard for the diagnosis. Despite its transitory characteristic Takotsubo syndrome should not be considered a benign condition since complications occur in almost half of the patients, and the mortality rate reaches 4-5%. Lately, it has been revealed that Takotsubo syndrome can also lead to permanent myocardial damage due to the massive release of catecholamines that leads to myocardial dysfunction. Different mechanisms have been advanced to explain this fascinating syndrome, such as plaque rupture and thrombosis, coronary spasm, microcirculatory dysfunction, catecholamine toxicity, and activation of myocardial survival pathways. Here are still several issues with Takotsubo syndrome that need to be investigated: the complex relationship between the heart and the brain, the risk of permanent myocardial damage, and the impairment of cardiomyocyte. Our review aims to elucidate the pathophysiology and the mechanisms underlying this complex disease to manage the diagnostic and therapeutic algorithms to create a functional synergy between physicians and patients.

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Pathophysiology of Takotsubo Syndrome as A Bridge to Personalized Treatment

Cited by 4 publications

References 59 publications

A Case Series of Concomitant Cardiac Electrical Disease among Takotsubo Syndrome Patients and Literature Review

A Case Series of Concomitant Cardiac Electrical Disease among Takotsubo Syndrome Patients and Literature Review

Síndrome de Takotsubo: complicación cardiovascular del accidente cerebrovascular

Takotsubo Syndrome: The Secret Crosstalk between Heart and Brain

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