Update of Takotsubo cardiomyopathy: Present experience and outlook for the future

The Heart Is at Risk: Understanding Stroke-Heart-Brain Interactions with Focus on Neurogenic Stress Cardiomyopathy—A Review

“…In patients with classic uncomplicated TTC, the most appropriate and beneficial therapeutic intervention is the combination of β-blockers with angiotensin-converting enzyme (ACE) inhibitors. 157 Indeed, several studies demonstrate the therapeutic benefits of β-blockers, as they lead to rapid recovery of LV function and inhibition of the Gs-protein metabolic pathway, while ACE inhibitors prevent vasospasm and reduce hypertension. [158][159][160] Additionally, previous research data demonstrate that pre-existing treatment with β-blockers is associated with milder stroke severity due to their sympatholytic action, anti-inflammatory properties, and reduction of norepinephrine-stimulated my-ocytes apoptosis.…”

“…157,171 If cardiogenic shock is accompanied by LVOTO, the treatment of choice is combined with fluid administration of β-blockers; phenylephrine administration may also be considered in preference to positive inotro-pic drugs (e.g., norepinephrine). 157,[171][172][173] Because of its cardioprotective action and increase in blood supply to internal organs and intra-aortic balloon pump, the use of levosimendan should be evaluated in patients with refractory SAH-associated cardiogenic shock. 8,174,175 More clinical trials are required in order to indicate the optimal therapeutic management in patients with concurrent ABI and NSC and, consequently, improve their cardiac function and minimize secondary brain injury.…”

Complete estamation of patient with myocardial ischemia

“…Независимо от липсата на стенози на големите епикардни артерии, наличието на микросъдова болест с редукция на КР води до влошена прогноза при болните. Наскоро публикуван метаанализ на 79 проучвания с почти 60 000 пациенти, показва, че патологичният коронарен резерв води до влошена прогноза при болните със съответно 3,78 пъти повишена смъртност и 3,45 пъти повече нежелани събития спрямо контролите [48]. При това, при болните с изолирана микроваскуларна дисфункция, без патология на големите епикардни артерии, пониженият КР е свързан с 5,44 пъти повишен риск от смърт и 3,56 пъти на всички нежелани събития (MACE).…”

Recent highlights on acute myocardial infarction and takotsubo syndrome from the International Journal of Cardiology: Heart & Vasculature

“…Takotsubo Syndrome (TTS), also known as stress cardiomyopathy, is a disorder characterized by acute and transient wall motion abnormalities with left ventricular systolic [and diastolic] dysfunction, often associated with a stressful, emotional, or physical event [31] . Although initially thought to be a benign condition, it is increasingly recognized as a potentially life-threatening condition that could be associated with severe complications such as ventricular arrhythmias and cardiogenic shock [32] . Females in their seventh or eighth decade of life are more prone to TTS.…”

“…Females in their seventh or eighth decade of life are more prone to TTS. The predominance of TTS in women has been related to the absence of cardioprotective effects of androgens [32] . The race might contribute to the incidence and prognosis of TTS [33] .…”