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      Takotsubo syndrome

      review-article
      Author(s): a , * , b
      Publication date (Electronic):
      Journal: Indian Heart Journal
      Publisher: Elsevier
      Keywords: ACS, acute coronary syndrome, ECG, electrocardiography, ECHO, echocardiography, EF, ejection fraction, ECMO, extra-corporeal membrane oxygenator, HPA, hypothalamus pituitary axis, IABP, intra-aortic balloon pump, LVAD, Left ventricle assist device, LMWH, Low molecular weight heparin, LVOT, left ventricle outflow tract, LV, left Ventricle, MR, mitral regurgitation, MRI, magnetic resonance imaging, NIS, Nationwide Inpatient Sample, NSTEMI, Non-ST elevation myocardial infarction, NT-proBNP, N-terminal pro brain natriuretic peptide, RWMA, regional wall motion abnormality, SAM, systolic anterior motion, STEMI, ST elevation myocardial infarction, SAH, subarachnoid haemorrhage, TS, Takotsubo syndrome, Left ventricular failure (LVF), Regional wall motion abnormalities (RWMA), Apical ballooning syndrome

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          Abstract

          Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary syndrome. Pathogenesis is complex and may involve brain-heart axis and neuro-hormonal stunning of the myocardium. Coronary angiography reveals normal epicardial arteries with no obstruction or spasm. NT-ProBNP maybe remarkably elevated. Regional wall motion akinesia (RWMA) of left ventricle extends beyond the territory of one coronary artery. Reduced left ventricle ejection fraction (LVEF) and RWMA recover in 6–12 weeks. Prognosis is generally good. Recent meta-analysis shows in-hospital mortality of 1–4.5% and recurrence rate of 5–10% during five year follow-up.

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          Most cited references47

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          Takotsubo cardiomyopathy: a new form of acute, reversible heart failure.

          Yoshihiro Akashi, David S. Goldstein, Giuseppe Barbaro … (2008)
          Article 0 comments Cited 218 times – based on 0 reviews     Review now
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            Four-year recurrence rate and prognosis of the apical ballooning syndrome.

            Ahmad Elesber, Abhiram Prasad, Ryan Lennon … (2007)
            This study sought to assess the long-term prognosis of patients with apical ballooning syndrome (ABS). Apical ballooning syndrome is a recently described acute cardiac syndrome of uncertain etiology and prognosis. We retrospectively identified 100 unselected patients with a confirmed diagnosis of ABS by angiography. Recurrences of ABS and mortality were recorded. Over a mean follow-up of 4.4 +/- 4.6 years, 31 patients continued to have episodes of chest pain and 10 patients had recurrence of ABS, for a recurrence rate of 11.4% over the first 4 years. Seventeen patients died in 4.7 +/- 4.8 years of follow-up. There was no difference in survival or in cardiovascular survival to an age- and gender-matched population. The recurrence rate for ABS was 11.4% over 4 years after initial presentation. Recurrence of chest pain is common. Four-year survival was not different from that in an age-matched and gender-matched population.
            Article 0 comments Cited 115 times – based on 0 reviews     Review now
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              Epidemiology and pathophysiology of Takotsubo syndrome.

              Yoshihiro Akashi, Holger M. Nef, Alexander R Lyon (2015)
              Takotsubo syndrome is an acute cardiac syndrome first described in 1990 and characterized by transient left ventricular dysfunction affecting more than one coronary artery territory, often in a circumferential apical, mid-ventricular, or basal distribution. Several pathophysiological explanations have been proposed for this syndrome and its intriguing appearance, and awareness is growing that these explanations might not be mutually exclusive. The reversible apical myocardial dysfunction observed might result from more than one pathophysiological phenomenon. The pathophysiology of Takotsubo syndrome is complex and integrates neuroendocrine physiology, potentially involving the cognitive centres of the brain, and including the hypothalamic-pituitary-adrenal axis. Cardiovascular responses are caused by the sudden sympathetic activation and surge in concentrations of circulating catecholamines. The multiple morphological changes seen in the myocardium match those seen after catecholamine-induced cardiotoxicity. The acute prognosis and recurrence rate are now known to be worse than initially thought, and much still needs to be learned about the epidemiology and the underlying pathophysiology of this fascinating condition in order to improve diagnostic and treatment pathways.
              Article 0 comments Cited 103 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Sanjiv Gupta
                Journal
                Journal ID (nlm-ta): Indian Heart J
                Journal ID (iso-abbrev): Indian Heart J
                Title: Indian Heart Journal
                Publisher: Elsevier
                ISSN (Print): 0019-4832
                Publication date (Print): Jan-Feb 2018
                Publication date (Electronic): 13 September 2017
                Volume: 70
                Issue: 1
                Pages: 165-174
                Affiliations
                [a ]NH Narayana Multispeciality Hospital, Jaipur, India
                [b ]Heart and Diabetic Clinic, B-19, Rajender Marg, Bapu Nagar, Jaipur, India
                Author notes
                [* ]Correspondence to: Flat No 403, Golden Sobhagya, B-81, Rajender Marg, Bapu Nagar, Jaipur 15, India. gupta98tanya@ 123456gmail.com
                Article
                Publisher ID: S0019-4832(17)30196-7
                DOI: 10.1016/j.ihj.2017.09.005
                PMC ID: 5902911
                PubMed ID: 29455773
                SO-VID: 8c963baa-08f1-46e7-8518-672bf1c51294
                Copyright © © 2017 Published by Elsevier B.V. on behalf of Cardiological Society of India.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 17 March 2017
                Date accepted : 11 September 2017
                Categories
                Subject: Review Article

                Keywords: acs, acute coronary syndrome,ecg, electrocardiography,echo, echocardiography,ef, ejection fraction,ecmo, extra-corporeal membrane oxygenator,hpa, hypothalamus pituitary axis,iabp, intra-aortic balloon pump,lvad, left ventricle assist device,lmwh, low molecular weight heparin,lvot, left ventricle outflow tract,lv, left ventricle,mr, mitral regurgitation,mri, magnetic resonance imaging,nis, nationwide inpatient sample,nstemi, non-st elevation myocardial infarction,nt-probnp, n-terminal pro brain natriuretic peptide,rwma, regional wall motion abnormality,sam, systolic anterior motion,stemi, st elevation myocardial infarction,sah, subarachnoid haemorrhage,ts, takotsubo syndrome,left ventricular failure (lvf),regional wall motion abnormalities (rwma),apical ballooning syndrome
                Data availability:
                Keywords: acs, acute coronary syndrome, ecg, electrocardiography, echo, echocardiography, ef, ejection fraction, ecmo, extra-corporeal membrane oxygenator, hpa, hypothalamus pituitary axis, iabp, intra-aortic balloon pump, lvad, left ventricle assist device, lmwh, low molecular weight heparin, lvot, left ventricle outflow tract, lv, left ventricle, mr, mitral regurgitation, mri, magnetic resonance imaging, nis, nationwide inpatient sample, nstemi, non-st elevation myocardial infarction, nt-probnp, n-terminal pro brain natriuretic peptide, rwma, regional wall motion abnormality, sam, systolic anterior motion, stemi, st elevation myocardial infarction, sah, subarachnoid haemorrhage, ts, takotsubo syndrome, left ventricular failure (lvf), regional wall motion abnormalities (rwma), apical ballooning syndrome

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