The Role of Echo cardiography in Diagnosis and Follow Up of Patients with Takotsubo Cardiomyopathy or Acute Ballooning Syndrome

Naser, Nabil; Buksa, M; Kušljugić, Zumreta; Terzić, Ibrahim; Sokolović, Šekib; Hodžić, Enisa

doi:10.5455/medarh.2011.65.287-290

Cited by 8 publications

(8 citation statements)

References 25 publications

(19 reference statements)

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“…Table 1), in line with the idea that the encapsulation of LYC prevents the deleterious remodelling associated with LYC in its free form. Interestingly, LYC-treated-mice exhibited a ballooned apex reminiscent of Tako-tsubo cardiomyopathy1314. In light of this particular type of hypertrophic wall remodelling and the dilated apex observed in the LYC group, we also assessed the EF by the Simpson method to circumvent the limitations of the Teicholz method.…”

Section: Resultsmentioning

confidence: 99%

“…This hypertrophic adaptation helps to maintain or enhance blood ejection but, at the same time, compromises chamber filling due to LV stiffness and, thereby, leads to a progressive deterioration of myocardial function until end-stage failure262728. The ballooned apex of the heart was reminiscent of broken heart syndrome or drug-induced Tako-tsubo cardiomyopathy1314.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Biodegradable Polymeric Nanocapsules Prevent Cardiotoxicity of Anti-Trypanosomal Lychnopholide

Branquinho

Roy

Farah

et al. 2017

Sci Rep

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Chagas disease is a neglected parasitic disease caused by the protozoan Trypanosoma cruzi. New antitrypanosomal options are desirable to prevent complications, including a high rate of cardiomyopathy. Recently, a natural substance, lychnopholide, has shown therapeutic potential, especially when encapsulated in biodegradable polymeric nanocapsules. However, little is known regarding possible adverse effects of lychnopholide. Here we show that repeated-dose intravenous administration of free lychnopholide (2.0 mg/kg/day) for 20 days caused cardiopathy and mortality in healthy C57BL/6 mice. Echocardiography revealed concentric left ventricular hypertrophy with preserved ejection fraction, diastolic dysfunction and chamber dilatation at end-stage. Single cardiomyocytes presented altered contractility and Ca2+ handling, with spontaneous Ca2+ waves in diastole. Acute in vitro lychnopholide application on cardiomyocytes from healthy mice also induced Ca2+ handling alterations with abnormal RyR2-mediated diastolic Ca2+ release. Strikingly, the encapsulation of lychnopholide prevented the cardiac alterations induced in vivo by the free form repeated doses. Nanocapsules alone had no adverse cardiac effects. Altogether, our data establish lychnopholide presented in nanocapsule form more firmly as a promising new drug candidate to cure Chagas disease with minimal cardiotoxicity. Our study also highlights the potential of nanotechnology not only to improve the efficacy of a drug but also to protect against its adverse effects.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Biodegradable Polymeric Nanocapsules Prevent Cardiotoxicity of Anti-Trypanosomal Lychnopholide

Branquinho

Roy

Farah

et al. 2017

Sci Rep

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“…However, the basis for hypotension in TTC is not clear. Overall LV systolic function is often only mildly impaired; for example, left ventricular ejection fraction (LVEF) is often near normal . Furthermore, marked release of catecholamines should theoretically protect against hypotension via both pressor and positive inotropic effects.…”

Section: Introductionmentioning

confidence: 99%

Dissociation Between Severity of Takotsubo Cardiomyopathy and Presentation With Shock or Hypotension

Chong¹,

Neil²,

Nguyen³

et al. 2013

Clinical Cardiology

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Background: Takotsubo cardiomyopathy (TTC) is increasingly well-recognized as a cause of chest-pain syndromes, especially in aging females. The most common complications of TTC occur in the first 24 hours post onset of symptoms and include shock and/or arrhythmias. Hypothesis: We tested the hypothesis that the severity of early hypotension in TTC reflects the extent of myocardial involvement and dysfunction. Methods: In 80 consecutive TTC patients, correlates of blood pressure on the day of admission were sought via univariate followed by multivariate analysis. Results: Mean systolic blood pressure (SBP) on day 1 was 120 ± 24 (SD) mm Hg. During the first 3 days of admission, 39% of patients had SBP <90 mm Hg, and 9% died and/or required intra-aortic balloon pump insertion. The extent of release of N-terminal pro-brain natriuretic peptide, with its potential correlate of associated vasodilator activity, varied inversely with pulmonary-artery saturation, a measure of cardiac output. However, there was no significant relationship between normetanephrine release and SBP. On multivariate analyses there was no significant relationship between SBP and (1) wall-motion score index (as an index of left-ventricular systolic dysfunction) or (2) T 2 enhancement on cardiac magnetic resonance imaging and peak N-terminal pro-brain natriuretic peptide (as indices of myocardial inflammation). Conclusions: Although severe hypotension and shock occur commonly during acute stages of TTC, these complications are multifactorial in origin, probably representing a combination of impaired inotropic state and vasodilatation. Importantly, initial hypotension does not imply severe left ventricular inflammation or systolic dysfunction.

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“…Cases that appear during the intraoperative period represent a diagnostic challenge for the anesthesiologist. [ 11 12 ] Among the differential diagnoses of our case are ACS, a reaction to medications and pulmonary edema due to negative pressure. The literature contains multiple case reports related to the administration of medications, with the most prevalent being the alpha-adrenergic drugs, fundamentally adrenaline.…”

Section: Discussionmentioning

confidence: 99%

Transesophageal echo diagnosis of perioperative unusual transient left ventricular apical ballooning syndrome

Mantilla¹,

Móntes²,

Amaya³

2016

Ann Card Anaesth

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Stress cardiomyopathy, or Takotsubo syndrome, is a widely recognized cardiac pathology with a clinical presentation similar to acute coronary syndrome and related to physical or emotional stress. Perioperatively, it is challenging to identify it given the variety of forms and scenarios in which it can present. We describe a 22-year-old patient with an atypical presentation of Takotsubo syndrome during anesthesia induction, which highlights the usefulness of transesophageal echocardiography for the initial diagnosis.

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The Role of Echo cardiography in Diagnosis and Follow Up of Patients with Takotsubo Cardiomyopathy or Acute Ballooning Syndrome

Cited by 8 publications

References 25 publications

Biodegradable Polymeric Nanocapsules Prevent Cardiotoxicity of Anti-Trypanosomal Lychnopholide

Biodegradable Polymeric Nanocapsules Prevent Cardiotoxicity of Anti-Trypanosomal Lychnopholide

Dissociation Between Severity of Takotsubo Cardiomyopathy and Presentation With Shock or Hypotension

Transesophageal echo diagnosis of perioperative unusual transient left ventricular apical ballooning syndrome

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