Journal ArticleDOI
Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress
Ilan S. Wittstein,David R. Thiemann,Joao A.C. Lima,Kenneth L. Baughman,Steven P. Schulman,Gary Gerstenblith,Katherine C. Wu,Jeffrey J. Rade,Trinity J. Bivalacqua,Hunter C. Champion +9 more
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TLDR
Emotional stress can precipitate severe, reversible left ventricular dysfunction in patients without coronary disease andaggerated sympathetic stimulation is probably central to the cause of this syndrome.Abstract:
background Reversible left ventricular dysfunction precipitated by emotional stress has been reported, but the mechanism remains unknown. methods We evaluated 19 patients who presented with left ventricular dysfunction after sudden emotional stress. All patients underwent coronary angiography and serial echocardiography; five underwent endomyocardial biopsy. Plasma catecholamine levels in 13 patients with stress-related myocardial dysfunction were compared with those in 7 patients with Killip class III myocardial infarction. results The median age of patients with stress-induced cardiomyopathy was 63 years, and 95 percent were women. Clinical presentations included chest pain, pulmonary edema, and cardiogenic shock. Diffuse T-wave inversion and a prolonged QT interval occurred in most patients. Seventeen patients had mildly elevated serum troponin I levels, but only 1 of 19 had angiographic evidence of clinically significant coronary disease. Severe left ventricular dysfunction was present on admission (median ejection fraction, 0.20; interquartile range, 0.15 to 0.30) and rapidly resolved in all patients (ejection fraction at two to four weeks, 0.60; interquartile range, 0.55 to 0.65; P<0.001). Endomyocardial biopsy showed mononuclear infiltrates and contraction-band necrosis. Plasma catecholamine levels at presentation were markedly higher among patients with stressinduced cardiomyopathy than among those with Killip class III myocardial infarction (median epinephrine level, 1264 pg per milliliter [interquartile range, 916 to 1374] vs. 376 pg per milliliter [interquartile range, 275 to 476]; norepinephrine level, 2284 pg per milliliter [interquartile range, 1709 to 2910] vs. 1100 pg per milliliter [interquartile range, 914 to 1320]; and dopamine level, 111 pg per milliliter [interquartile range, 106 to 146] vs. 61 pg per milliliter [interquartile range, 46 to 77]; P<0.005 for all comparisons). conclusions Emotional stress can precipitate severe, reversible left ventricular dysfunction in patients without coronary disease. Exaggerated sympathetic stimulation is probably central to the cause of this syndrome.read more
Citations
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Journal ArticleDOI
Pheochromocytoma induced cardiogenic shock with rapid recovery of ventricular function.
TL;DR: A patient in cardiogenic shock dependant on an intra‐aortic balloon pump and vasopressor support who completely recovered cardiac function within 96 h of hospitalization is presented.
Journal ArticleDOI
Interaction of systolic blood pressure and resting heart rate with clinical outcomes in takotsubo syndrome: insights from the International Takotsubo Registry
Michael Böhm,Victoria L. Cammann,Jelena-R. Ghadri,Christian Ukena,Sebastiano Gili,Davide Di Vece,Ken Kato,Katharina J. Ding,Konrad A. Szawan,Jozef Micek,Stjepan Jurisic,Fabrizio D'Ascenzo,Antonio H. Frangieh,Delia Rechsteiner,Burkhardt Seifert,Frank Ruschitzka,Thomas F. Lüscher,Thomas F. Lüscher,Christian Templin +18 more
TL;DR: The present study aimed to determine the prognostic impact of resting heart rate (HR) and systolic blood pressure (SBP) in takotsubo syndrome (TTS).
Journal ArticleDOI
Impact of aspirin on takotsubo syndrome: a propensity score‐based analysis of the InterTAK Registry
Fabrizio D'Ascenzo,Sebastiano Gili,Maurizio Bertaina,Mario Iannaccone,Victoria L. Cammann,Davide Di Vece,Ken Kato,Andrea Saglietto,Konrad A. Szawan,Antonio H. Frangieh,Beatrice Boffini,Margherita Annaratone,Annahita Sarcon,Rena A. Levinson,Rena A. Levinson,Jennifer Franke,L. Christian Napp,Miłosz Jaguszewski,Michel Noutsias,Thomas Münzel,Maike Knorr,Susanne Heiner,Hugo A. Katus,Christof Burgdorf,Heribert Schunkert,Holger Thiele,Johann Bauersachs,Carsten Tschöpe,Burkert Pieske,Lawrence Rajan,Guido Michels,Roman Pfister,Alessandro Cuneo,Claudius Jacobshagen,Gerd Hasenfuß,Mahir Karakas,Wolfgang Koenig,Wolfgang Rottbauer,Samir M. Said,Ruediger C. Braun-Dullaeus,Adrian P. Banning,Florim Cuculi,Richard Kobza,Thomas Fischer,Tuija Vasankari,K.E. Juhani Airaksinen,Grzegorz Opolski,Rafal Dworakowski,Philip MacCarthy,Christoph Kaiser,Stefan Osswald,Leonarda Galiuto,Filippo Crea,Wolfgang Dichtl,Wolfgang-Michael Franz,Klaus Empen,Stephan B. Felix,Clément Delmas,Olivier Lairez,Ibrahim El-Battrawy,Ibrahim Akin,Martin Borggrefe,John D. Horowitz,Martin Kozel,Petr Tousek,Petr Widimský,Ekaterina Gilyarova,Alexandra Shilova,Mikhail Gilyarov,Giuseppe Biondi-Zoccai,David E. Winchester,Christian Ukena,Michael Neuhaus,Jeroen J. Bax,Abhiram Prasad,Carlo Di Mario,Michael Böhm,Mauro Gasparini,Frank Ruschitzka,Eduardo Bossone,Rodolfo Citro,Mauro Rinaldi,Gaetano M. De Ferrari,Thomas F. Lüscher,Thomas F. Lüscher,Jelena R. Ghadri,Christian Templin +86 more
TL;DR: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS), and to establish a smoking cessation strategy for aspirin use in patients with TTS.
Journal ArticleDOI
Elderly women diagnosed with nonspecific chest pain may be at increased cardiovascular risk
Jennifer G. Robinson,Robert B. Wallace,Marian C. Limacher,Alicia Sato,Barbara B. Cochrane,Sylvia Wassertheil-Smoller,Judith K. Ockene,Patricia L. Blanchette,Marcia G. Ko +8 more
TL;DR: Older women discharged with a diagnosis of NSCP may be at increased risk of CHD morbidity and further research is needed to replicate these findings in other populations.
Journal ArticleDOI
Takotsubo Cardiomyopathy: Do the Genetics Matter?
Giuseppe Limongelli,Raffaella D’Alessandro,Daniele Masarone,Valeria Maddaloni,Olga Vriz,Rosalba Minisini,Rodolfo Citro,Paolo Calabrò,Maria Giovanna Russo,Raffaele Calabrò,Giuseppe Pacileo,Eduardo Bossone,Perry M. Elliott +12 more
TL;DR: The role of genetic mechanisms that might explain or modulate the pathogenesis of Takotsubo cardiomyopathy are explored.
References
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Journal ArticleDOI
Molecular and Cellular Mechanisms of Myocardial Stunning
Roberto Bolli,Eduardo Marbán +1 more
TL;DR: An important implication of the phenomenon of myocardial stunning is that so-called chronic hibernation may in fact be the result of repetitive episodes of stunning, which have a cumulative effect and cause protracted postischemic dysfunction.
Journal ArticleDOI
Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction.
Satoshi Kurisu,Hikaru Sato,Takuji Kawagoe,Masaharu Ishihara,Yuji Shimatani,Kenji Nishioka,Yasuyuki Kono,Takashi Umemura,Suji Nakamura +8 more
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