Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: A novel cardiac syndrome mimicking acute myocardial infarction

Kurisu, Satoshi; Sato, Hajime; Kawagoe, Takuji; Ishihara, Masaharu; Sakai, Yuji; Nishioka, Kenji; Kono, Yasuyuki; Umemura, Takashi; Nakamura, Suji

doi:10.1067/mhj.2002.120403

Cited by 775 publications

(641 citation statements)

References 20 publications

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“…[1][2][3][4][5][6] Clinically, it is characterized by acute onset of chest pain and is associated with ECG changes such as ST elevation, ST depression or deep T-wave inversion. It has been named takotsubo cardiomyopathy because of the shape taken by the left ventricle.…”

Section: Introductionmentioning

confidence: 99%

Effects of metoprolol on epinephrine-induced takotsubo-like left ventricular dysfunction in non-human primates

et al. 2009

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Takotsubo cardiomyopathy, alternatively known as stress cardiomyopathy, is an increasingly recognized clinical syndrome characterized by acute reversible apical ventricular dysfunction. To elucidate the mechanism, we tried to make a new model of takotsubo-like cardiomyopathy in non-human primates. Echocardiography revealed that repeated intravenous infusion of epinephrine overdose in cynomolgus monkeys induced takotsubo-like cardiomyopathy, which is characterized by progressive left ventricle and depressed systolic function with severe hypokinesis in apical regions and hyperkinesis in the basal region. Although this cardiac dysfunction almost normalized after a month even without any treatment, metoprolol, a b-blocker, improved the decreased ejection fraction earlier than in the control. Luxol fast blue staining, which is useful for estimating myocytolysis, showed that increased myocytolysis was observed in the apical ventricle of the epinephrine-infused heart. Metoprolol diminished epinephrine-induced cardiomyocytolysis. To explain the mechanism of takotsubo myopathy and the effect of metoprolol, gene expressions in apical or basal ventricle were compared. Heart failure-related genes, such as brain natriuretic peptide, connective tissue growth factor and osteopontin; calcium signaling-related genes, such as ryanodine receptor 2, sarcoendoplasmic reticulum Ca 2+ -ATPase 2A2 and adenylate cyclase 7; renin-angiotensin system-related genes, such as angiotensinogen, angiotensin II receptor, type 1 and type 2; and mitochondria-related genes, such as peroxisome proliferatoractivated receptor-c co-activator-1a, cytochrome c and transcription factor A mitochondrial, were significantly changed at the apical ventricle rather than at the basal ventricle. The changes of some genes improved with metoprolol treatment. These results indicate that this model is valuable in understanding the pathogenesis of takotsubo cardiomyopathy and the effectivity of b-blockers.

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Section: Introductionmentioning

confidence: 99%

Effects of metoprolol on epinephrine-induced takotsubo-like left ventricular dysfunction in non-human primates

et al. 2009

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“…Otra hipótesis se refi ere a alteraciones en la microcirculación coronaria aunque sin causalidad directa demostrada 5 . La miocarditis puede presentarse con características similares a las del STT, aunque resultados negativos en biopsias miocárdicas y en anticuerpos antivirales, la hace poco probable como etiología 6 .…”

Section: Discussionunclassified

Síndrome de Tako-Tsubo: caso clínico

et al. 2011

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“…We, as well as other groups, have reported several possible mechanisms of takotsubo syndrome including epicardial coronary spasm, microvascular dysfunction (spasm), catecholamine cardiotoxicity (1)(2)(3)(4)(5)(6), but the precise cause remains unclear. Excessive catecholamine production has been known to induce left ventricular dysfunction in patients with pheochromocytoma (18).…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, this asynergy has been widely called takotsubo-like left ventricular dysfunction (1)(2)(3)(4)(5)(6)(7)(8)(9), and this syndrome is gradually being established worldwide (10)(11)(12)(13)(14)(15)(16)(17). Major clinical characteristics are that (1) most patients are elderly women; (2) the symptoms are similar to those of acute myocardial infarction; (3) takotsubo-like left ventricular dysfunction, which extends over more than one coronary artery region, is transient and dramatically resolves within several weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Takotsubo syndrome is characterized by transient left ventricular apical wall motion abnormality with electrocardiographic changes and minimal myocardial enzymatic release mimicking acute myocardial infarction, but without significant coronary artery disease (1)(2)(3)(4)(5)(6)(7)(8)(9). To date, we have reported several early angiographic characteristics of takotsubo syndrome such as left ventricular outflow tract obstruction (2), mitral regurgitation (2), apical thrombus formation (3) or reduced coronary blood flow (2).…”

Section: Introductionmentioning

confidence: 99%

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