The Sympathetic Nervous System in the Pathogenesis of Takotsubo Syndrome

Wittstein, Ilan S.

doi:10.1016/j.hfc.2016.06.012

Cited by 42 publications

(29 citation statements)

References 107 publications

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“…Heart rate variability (HRV) analysis has been performed in both the acute phase and at follow-up of TS by several investigators [ 90 ]. The indices of HRV were markedly depressed within 48 h after hospital admission but normalized at the 3-month follow-up [ 91 ].…”

Section: Autonomic Nervous System and Tsmentioning

confidence: 99%

Epidemiology, pathogenesis, and management of takotsubo syndrome

2017

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Takotsubo syndrome is a recently recognized acute cardiac disease entity with a clinical presentation resembling that of an acute coronary syndrome. The typical takotsubo syndrome patient has a unique circumferential left (bi-) ventricular contraction abnormality profile that extends beyond a coronary artery supply territory and appears to follow the anatomical cardiac sympathetic innervation. The syndrome predominantly affects postmenopausal women and is often preceded by emotional or physical stress. Patients with predisposing factors such as malignancy and other chronic comorbidities are more prone to suffer from takotsubo syndrome. The pathogenesis of takotsubo syndrome is elusive. Several pathophysiological mechanisms involving myocardial ischemia (multivessel coronary artery spasm, microvascular dysfunction, aborted myocardial infarction), left ventricular outlet tract obstruction, blood-borne catecholamine myocardial toxicity, epinephrine-induced switch in signal trafficking, and autonomic nervous system dysfunction have been proposed. The syndrome is usually reversible; nevertheless, during the acute stage, a substantial number of patients develop severe complications such as arrhythmias, heart failure including pulmonary edema and cardiogenic shock, thromboembolism, cardiac arrest, and rupture. Treatment of precipitating factors, predisposing diseases, and complications is fundamental during the acute stage of the disease. The epidemiology, pathogenesis, and management of takotsubo syndrome are reviewed in this paper.

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Section: Autonomic Nervous System and Tsmentioning

confidence: 99%

Epidemiology, pathogenesis, and management of takotsubo syndrome

2017

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“…From a psychophysiological perspective, an excessive activation of the sympathetic nervous system is discussed to be a major factor for the development of TTC and several studies suggest that elevated catecholamine concentrations function as mediating mechanism (Borchert et al, 2017;Wittstein, 2016;Frustaci et al, 1991, Khullar et al, 1989.. Nonetheless, the etiology of TTC remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial and physical long-term outcome in patients with a history of takotsubo cardiomyopathy or myocardial infarction - a multi-centered case control study

Olliges

Burgdorf

Ladwig

et al. 2020

Psychology, Health & Medicine

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Physical long-term impacts of Takotsubo Cardiomyopathy (TTC) remain controversial and an underestimation of their severity becomes increasingly evident. Even less is known about mental long-term impacts of TTC. This study aims at a better understanding of the physical and mental long-term effects of TTC in comparison to myocardial infarctions (MI). On average 5 years after disease onset, 68 TTC patients and 68 age-and sex-matched MI patients were assessed for disease-related quality of life, depression, anxiety, chronic stress, social support, resilience, and life events prior to disease onset. Scores of TTC and MI patients were compared to each other and to normative references values. Regression analyses were used to evaluate the predictive value of the number of life events prior to disease onset for physical and mental long-term outcomes. Both groups displayed higher scores in depression and anxiety, higher levels of chronic stress, and lower scores in physical and mental quality of life in comparison to norm samples, while social support did not differ from norms. No differences between the two patient groups were observed. Within both groups, the majority of patients (TTC: 69.1%; MI: 60.3%) reported stressful life events prior to disease onset. In TTCs and MIs, the number of events had a significant impact on long-term mental health and chronic stress. Notably, both patient collectives scored higher in resilience than healthy controls. Results suggest negative long-term impacts of TTC on mental and physical wellbeing, comparable to those of MI. Besides a good ARTICLE HISTORY

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“…Although there is no pathognomonic ECG in TTS, characteristic findings include ST-segment elevation at the time of presentation in about half of the cases, deep and diffuse T-wave inversion, and a markedly prolonged QT interval [ 7 ]. Different wall motion patterns in patients with typical and atypical TTS may translate into differences in ECG patterns [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Mid-ventricle Takotsubo in a Patient with Goodpasture Syndrome

Zablah

Montañez-Valverde

Hurtado-de-Mendoza

et al. 2018

Cureus

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Takotsubo syndrome (TTS) is characterized by transient, regional systolic dysfunction of the left ventricle, often mimicking acute coronary syndrome. Atypical variants of this syndrome with mid-ventricular, basal, and focal wall motion patterns are increasingly diagnosed and show different clinical features compared to typical TTS. Even though TTS was generally considered a benign condition, continuous and strict monitoring is necessary to diagnose potentially life-threating complications. This is the first case report, to our knowledge, of atypical TTS in a patient with Goodpasture syndrome triggered by acute kidney injury (AKI).

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The Sympathetic Nervous System in the Pathogenesis of Takotsubo Syndrome

Cited by 42 publications

References 107 publications

Epidemiology, pathogenesis, and management of takotsubo syndrome

Epidemiology, pathogenesis, and management of takotsubo syndrome

Psychosocial and physical long-term outcome in patients with a history of takotsubo cardiomyopathy or myocardial infarction - a multi-centered case control study

Mid-ventricle Takotsubo in a Patient with Goodpasture Syndrome

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