Troponin I/ejection fraction ratio: A new index to differentiate Takotsubo cardiomyopathy from myocardial infarction

Novo, Giuseppina; Giambanco, Salvatore; Bonomo, Vito; Sutera, Maria Rita; Giambanco, Francesco; Rotolo, Antonino; Evola, Salvatore; Assennato, Pasquale; Novo, Salvatore

doi:10.1016/j.ijcard.2014.11.186

Cited by 16 publications

(7 citation statements)

References 20 publications

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“…But we believed that Takotsubo cardiomyopathy stood a less possibility. The reasons were as follows: first, there was no risk factors such like stress trigger, sepsis or pheochromocytoma; second, cTnI elevated so obviously (above 1, 000 multiple of normal upper limit) [ 10 ] and dropped slowly, and the ratio between peak cTnI and EF measured at admission was 95.9 (much higher than cut-off value of ≤60) [ 11 ]; third, cardiac MRI showed significant late gadolinium enhancement of subendocardial area in anterior wall [ 12 , 13 ]. But further follow-up was needed (such as echocardiography and cardiac MRI) to provide more evidence.…”

Section: Discussionmentioning

confidence: 99%

Myocardial infarction, symptomatic third degree atrioventricular block and pulmonary embolism caused by thalidomide: a case report

Zhang

Yang

Jin

et al. 2015

BMC Cardiovasc Disord

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BackgroundThalidomide has been reported to cause numerous thromboembolic events. Deep vein thrombosis and pulmonary embolism are more common. It can also cause bradycardia and even total atrioventricular block. Rarely, it causes coronary artery spasm and even myocardial infarction. But almost simultaneous onset of myocardial infarction, third degree atrioventricular block and pulmonary embolism in one patient has not been reported so far.Case presentationA 53-year old man presented because of chest pain, nausea and then syncope for several minutes. Previous medical history included neurodermitis for which thalidomide was given and hypercholesterolemia with simvastatin taking. The patient didn’t exhibit any other established risk factors for coronary artery disease. Electrocardiography showed sinus rhythm with third degree atrioventricular block and complete right bundle branch block, and precordial leads ST segment elevation. The diagnosis of acute coronary syndrome was suspected, but further coronary angiography demonstrated no flow-limiting lesions in coronary arteries, and temporary pacemaker was implanted. After admission, low SpO2 and elevated D-dimer level was mentioned. Further computed tomography pulmonary angiography revealed pulmonary embolism. Thalidomide was thought to be the cause of hypercoagulability and coronary spasm, so it was ceased immediately. Therapeutic low molecule weight heparin was initiated and then switched to warfarin with appropriate INR, and nifedipine was described for coronary spasm. The patient’s symptoms completely relived and SpO2 recovered, and atrioventricular block had disappeared during hospitalization with pacemaker removed.ConclusionThis is the very first case in which myocardial infarction, third degree atrioventricular block and pulmonary embolism almost simultaneously developed. We should be ware that anti-thrombotic prophylaxis, which needs further investigation for optimal drug and dosage, may be beneficial in thalidomide therapy. And it is also important to monitor patients taking thalidomide for signs and symptoms of bradycardia or higher degree atrioventricular block.

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Section: Discussionmentioning

confidence: 99%

Myocardial infarction, symptomatic third degree atrioventricular block and pulmonary embolism caused by thalidomide: a case report

Zhang

Yang

Jin

et al. 2015

BMC Cardiovasc Disord

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“…Los biomarcadores actuales no son específicos para diferenciar entre los SCA y la miocardiopatía por estrés 3,22,47 . Se ha descripto que por lo general la elevación de las TTus y la CPK son menos llamativas que en el IAMCEST [50][51][52] . El NT-Pro-BNP, en comparación, suele tener un pico más ele-vado que en el SCA, y está relacionado directamente con el grado de disfunción del VI.…”

Section: Discussionunclassified

Miocardiopatía por estrés: análisis de 17 casos

Young¹,

Guzmán²,

Pellegrini³

et al. 2018

RFEM

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Introducción. La miocardiopatía por estrés (MCS) o síndrome de takotsubo, se caracteriza por una disfunción sistólica aguda y transitoria que simula la presentación de un síndrome coronario agudo gatillada por un factor estresante psicológico o físico. Métodos. Se presenta una serie de casos de pacientes con MCS del Hospital Británico entre 2011 y 2016. Se describen las características de la población estudiada y factores epidemiológicos y clínicos asociados. Resultados. Se incluyeron 17 pacientes con una edad media de 62,5 años, de los cuales el 94% eran mujeres. Más del 70% presentaban uno o más factores de riesgo cardiovascular. La mayoría tenían valores elevados de los biomarcadores miocárdicos troponina T ultrasensible y creatinfosfokinasa. Se observó compromiso apical y medioventricular del ventrículo izquierdo con afectación moderada a severa de la fracción de eyección del ventrículo izquierdo e insuficiencia mitral variable. La evolución de la mayoría de los pacientes fue favorable. Discusión. La incidencia de este síndrome ha ido en aumento en la última década, debido al mayor conocimiento de la enfermedad y a los avances y disponibilidad de los medios de diagnóstico por imágenes. Los hallazgos de esta serie podrían contribuir a identificar rápidamente a los pacientes con miocardiopatía por estrés y optimizar su tratamiento y manejo clínico. Palabras clave: miocardiopatía de takotsubo; miocardiopatía por estrés; síndrome de corazón roto; síndrome de abombamiento apical, síndrome de aturdimiento apical transitorio del ventrículo izquierdo. Palabras clave: miocardiopatía de takotsubo, miocardiopatía por estrés, síndrome de corazón roto, síndrome de abombamiento apical, síndrome de aturdimiento apical transitorio del ventrículo izquierdo.

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“…Most patients with stress-induced cardiomyopathy (>95%) have electrocardiogram abnormalities that typically show ischemic ST-segment and T-wave changes, but his appearance is most likely to associate the presence of ACS than SCM [5,6]. Previous studies have shown that cardiac biomarkers such as cardiac troponin T or I, creatine-kinase myocardial band (CK-MB), and b-type natriuretic peptide (BNP) may play a role in the early clinical recognition of SCM, but the accuracy is low [7,8]. In patients with suspected stress cardiomyopathy, transthoracic echocardiography with color and tissue doppler is the preferred noninvasive imaging trial [5].…”

Section: Introductionmentioning

confidence: 99%

MFGE8, ALB, APOB, APOE, SAA1, A2M, and C3 as Novel Biomarkers for Stress Cardiomyopathy

Pan

Zhang

2020

Cardiovascular Therapeutics

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Background. Stress cardiomyopathy (SCM) is a transient reversible left ventricular dysfunction that more often occurs in women. Symptoms of SCM patients are similar to those of acute coronary syndrome (ACS), but little is known about biomarkers. The goals of this study were to identify the potentially crucial genes and pathways associated with SCM. Methods. We analyzed microarray datasets GSE95368 derived from the Gene Expression Omnibus (GEO) database. Firstly, identify the differentially expressed genes (DEGs) between SCM patients in normal patients. Then, the DEGs were used for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Finally, the protein-protein interaction (PPI) network was constructed and Cytoscape was used to find the key genes. Results. In total, 25 DEGs were identified, including 10 upregulated genes and 15 downregulated genes. These DEGs were mainly enriched in ECM-receptor interaction, dilated cardiomyopathy (DCM), human papillomavirus infection, and focal adhesion, whereas in GO function classification, they were mainly enriched in the extracellular region, positive regulation of the multicellular organismal process, establishment of localization, and intracellular vesicle. Conclusion. Seven hub genes contained APOE, MFGE8, ALB, APOB, SAA1, A2M, and C3 identified as hub genes of SCM, which might be used as diagnostic biomarkers or molecular targets for the treatment of SCM.

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Troponin I/ejection fraction ratio: A new index to differentiate Takotsubo cardiomyopathy from myocardial infarction

Cited by 16 publications

References 20 publications

Myocardial infarction, symptomatic third degree atrioventricular block and pulmonary embolism caused by thalidomide: a case report

Myocardial infarction, symptomatic third degree atrioventricular block and pulmonary embolism caused by thalidomide: a case report

Miocardiopatía por estrés: análisis de 17 casos

MFGE8, ALB, APOB, APOE, SAA1, A2M, and C3 as Novel Biomarkers for Stress Cardiomyopathy

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