Takotsubo cardiomyopathy, sepsis and clinical outcome: does gender matter?

Takotsubo Cardiomyopathy and Sepsis

“…Recently, the role of gender-based mechanisms contributing to the association between TTC and sepsis has been discussed in the literature. 57 Here, the authors report that although TTC is more prevalent in women and the great majority of the reported clinical cases had a favorable outcome, a possible gender effect in clinical outcome, especially on IHM in the presence of sepsis, could be possible and should be taken into account. 57 As support for this theory, Brinjikji et al, 53 in their study on 24 701 cases with TTC (89.0% women), showed that male patients had a higher mortality rate than women (11.0% vs 6.5%), and those with sepsis as well (24.9% vs 20.8%).…”

“…57 Here, the authors report that although TTC is more prevalent in women and the great majority of the reported clinical cases had a favorable outcome, a possible gender effect in clinical outcome, especially on IHM in the presence of sepsis, could be possible and should be taken into account. 57 As support for this theory, Brinjikji et al, 53 in their study on 24 701 cases with TTC (89.0% women), showed that male patients had a higher mortality rate than women (11.0% vs 6.5%), and those with sepsis as well (24.9% vs 20.8%). Moreover, Isogai et al, 52 in a study carried out on 3719 patients, demonstrated that patients with in-hospital TTC had a higher proportion of men than out-of-hospital patients with TTC (31.3% vs 21.3%).…”

“…32 The pathophysiologic mechanisms involved in catecholamineinduced cardiac toxicity may depend on inflammation, oxidative stress, and abnormal calcium handling, resulting in myocardial stunning, apoptosis, and necrosis. 57…”

Takotsubo syndrome and dialysis: an uncommon association?

“…The clinical outcome is favorable in most cases of TS and was likewise favorable in the cases of the present review. 12 However, two case series of in-hospital mortality of patients with TS showed that men with sepsis exhibited significantly higher inhospital mortality. 27,28 Infection results in sympathetic nervous system overstimulation and increases catecholamine plasma levels, which exert direct toxic effects on the heart that are dependent upon inflammation, oxidative stress, and abnormal calcium handling.…”

“…[4][5][6] These aspects are similar to those of myocardial infarction (MI) but different from those of other cardiac conditions. 7 Many medical diseases have been associated with TS, such as infectious diseases, 8 respiratory diseases, 9 endocrine disorders, 10 allergic diseases, 11 sepsis, 12 and even suicidal behavior. 13 We previously investigated the association between chronic kidney disease and cardiovascular diseases including MI, 14 pulmonary embolism, 15 and stroke.…”