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Takotsubo cardiomyopathy, clinical experience with the disease and one-year prognosis of patients


Authors: Petr Kubena 1;  Šárka Bohatá 2;  Jan Maňoušek 1;  Jindřich Špinar 1,3;  Jiří Pařenica 1,3
Authors‘ workplace: Interní kardiologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Jindřich Špinar, CSc., FESC 1;  Radiologická klinika LF MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Vlastimil A. Válek, CSc., MBA 2;  Mezinárodní centrum klinického výzkumu – Klinika kardiovaskulárních onemocnění FN u sv. Anny Brno, ředitel Gorazd B. Stokin, M. D., MSc., Ph. D. 3
Published in: Vnitř Lék 2015; 61(7-8): 619-625
Category: Original Contributions

Overview

Introduction:
Takotsubo cardiomyopathy (TCM) is a rare cardiac disease. In the acute phase it may imitate acute myocardial infarction of the anterior wall with ST elevations. This can be complicated by ventricular fibrilation or heart failure. The aim of this study is to show the characteristics of patients with takotsubo cardiomyopathy, the one year outcome and the application of magnetic resonance imaging of the heart in the diagnosis of this disease.

Methods:
Forty seven patients with takotsubo cardiomyopathy were enrolled in this study. Severe stenosis of coronary arteries was excluded by selective coronarography. In twelve patients the magnetic resonance imaging of the myocardium was performed. The patients were observed for at least 12 months.

Results:
89.4 % of takotsubo patients were women. Average of age was 62.3 ± 11.1 years. We found obvious stress factors in 18 patients (38.3 %). Many patients suffered from thyroid disorders, psychiatric, lung or allergic diseases. Thirty nine patients (83.0 %) had the apical and eight the midventricular type of takotsubo cardiomyopathy. In 42 patients (89.4 %) developed systolic left ventricular dysfunction and four patients (8.5 %) were in cardiogenic shock. Four patients (8.5 %) manifested ventricle fibrilation. One patient (2.1 %) had recurring takotsubo cardiomyopathy.

Conclusion:
Left ventricle function is mostly recovered in patients with takotsubo cardiomyopathy, but the acute phase can be complicated by cardiogenic shock or ventricular fibrilation. Magnetic resonance imaging of the heart is indicated in some patients to differentiate this cardiomyopathy from ischemic or inflammatory etiology.

Key words:
magnetic resonance imaging of the heart – prognosis – takotsubo cardiomyopathy


Sources

1. Hurst TR, Prasad A, Askew J et al. Takotsubo Cardiomyopathy: A Unique Cardiomyopathy With Variable Ventricular Morphology. JACC Cardiovasc Imaging 2010; 3(6): 641–649.

2. Xiu PY, Bchir MB, Sado D et al. An Unusual Cause of Electrocardiographic ST Elevation – Can the Japanese Fishing Industry Help Us? Takotsubo cardiomyopathy. Ann Emerg Med 2014; 63(2): 268–273.

3. Madhavan M, Prasad A. Proposed Mayo Clinic Criteria for the Diagnosis of Tako-Tsubo Cardiomyopathy and Long-Term Prognosis. Herz 2010; 35(4): 240–243.

4. Hurst RT, Askew JW, Reuss CS et al. Transient midventricular ballooning syndrome: a new variant. J Am Coll Cardiol 2006; 48(3): 579–583.

5. Kurowski V, Kaiser A, von Hof K et al. Apical and midventricular transient left ventricular dysfunction syndrome (takotsubo cardiomyopathy)* frequency, mechanisms, and prognosis. Chest 2007; 132(3): 809–816.

6. Bybee KA, Kara T, Prasad A et al. Systematic Review: Transient Left Ventricular Apical Ballooning: A Syndrome That Mimics ST-Segment Elevation Myocardial Infarction. Ann Intern Med 2004; 141(11): 858–865.

7. Parodi G, Citro R, Bellandi B et al. Tako-Tsubo Cardiomyopathy and Coronary Artery Disease: A Possible Association. Coron Artery Dis 2013; 24(6): 527–533.

8. Parsai C, O´Hanlon R, Prasad SK et al. Diagnostic and Prognostic Value of Cardiovascular Magnetic Resonance in Non-Ischaemic Cardiomyopathies. J Cardiovasc Magn Reson 2012; 14: 54. Dostupné z DOI: <http://dx.doi.org/10.1186/1532–429X-14–54>.

9. Wittstein IS, Thiemann DR, Lima JA et al. Neurohumoral Features of Myocardial Stunning Due to Sudden Emotional Stress. N Eng J Med 2005; 352(6): 539–548.

10. Wright PT, Tranter MH, Morley-Smith AC et al. Pathophysiology of Takotsubo Syndrome: Temporal Phases of Cardiovascular Responses to Extreme Stress. Circ J 2014; 78(7): 1550–1558.

11. Akashi YJ, Nakazawa K, Sakakibara M et al. 123I-MIBG Myocardial Scintigraphy in Patients with “Takotsubo” Cardiomyopathy. J Nucl Med 2004; 45(7): 1121–1127.

12. Schussler JM. Takotsubo cardiomyopathy following epidural steroid injection: yet another way to break the heart. Proc (Bayl Univ Med Cent) 2014; 27(2): 122.

13. Bybee KA, Prasad A, Barsness GW et al. Clinical characteristics and Thrombolysis In: Myocardial Infarction frame counts in women with transient left ventricular apical ballooning syndrome. Am J Cardiol 2004; 94(3): 343–346.

14. Dorfman TA, Iskandrian AE. Takotsubo cardiomyopathy: state-of-the-art review. J Nucl Cardiol 2009; 16(1): 122–134.

15. Ueyama T, Hano T, Kasamatsu K et al. Estrogen Attenuates the Emotional Stress-Induced Cardiac Responses in the Animal Model of Tako-Tsubo (Ampulla) Cardiomyopathy. J Cardiovasc Pharmacol 2003; 42(Suppl 1): S117-S119.

16. Citro R, Previtali M, Bovelli D et al. Chronobiological Patterns of Onset of Tako-Tsubo Cardiomyopathy: A Multicenter Italian Study. J Am Col Cardiol 2009; 54(2): 180–181.

17. Delmas C, Lairez O, Mulin E et al. Anxiodepressive Disorders and Chronic Psychological Stress Are Associated with Tako-Tsubo Cardiomyopathy – New Physiopathological Hypothesis. Circ J 2013; 77(1): 175–180.

18. Kosuge M, Ebina T, Hibi K et al. Simple and accurate electrocardiographic criteria to differentiate takotsubo cardiomyopathy from anterior acute myocardial infarction. J Am Col Cardiol 2010; 55(22): 2514–2516.

19. Johnson NP, Chavez JF, Mosley WJ et al. Performance of Electrocardiographic Criteria to Differentiate Takotsubo Cardiomyopathy from Acute Anterior ST Elevation Myocardial Infarction. Int J Cardiol 2013; 164(3): 345–348.

20. Aschermann M, Aschermann O. Tako-tsubo kardiomyopatie. Vnitř Lék 2009; 55(9): 792–796.

21. Elesber AA, Prasad A, Lennon JR et al. Four-Year Recurrence Rate and Prognosis of the Apical Ballooning Syndrome. J Am Coll Cardiol 2007; 50(5): 448–452.

22. Citro R, Rigo F, D´Andrea A et al. Echocardiographic Correlates of Acute Heart Failure, Cardiogenic Shock, and In-Hospital Mortality in Tako-Tsubo Cardiomyopathy. JACC Cardiovasc Imaging 2014; 7(2): 119–129.

23. Cacciotti L, Passaseo I, Marazzi G et al. Observational study on Takotsubo-like cardiomyopathy: clinical features, diagnosis, prognosis and follow-up. BMJ Open 2012; 2(5). pii: e001165. Dostupné z DOI: <http://dx.doi.org/10.1136/bmjopen-2012–001165>.

24. Caforio A, Tona F, Vinci A et al. Acute biopsy-proven lymphocytic myocarditis mimicking Takotsubo cardiomyopathy. Eur J Heart Fail 2009; 11(4): 428–431.

25. Bogaert J, Dymarkowski S, Taylor AM et al. Clinical Cardiac MR. Springer: Berlin Heidelberg 2012. ISBN 978–3–642–23034–9.

26. Mahrholdt H, Goedecke K, Wagner A et al. Cardiovascular magnetic resonance assessment of human myocarditis. Circulation 2004; 109(10): 1250–1258.

27. Friedrich MG, Sechtem U, Schulz-Menger A et al. Cardiovascular Magnetic Resonance in Myocarditis: AJACC White Paper. J Am Coll Cardiol 2009; 53(17): 1475–1487.

28. Finsterer J, Karim W. CNS-disease affecting the heart: Brain–heart disorders. J Neurol Sci 2014; 345(1–2): 8–14.

29. Redfors B, Shao Y, Omerovic E. Stress-induced cardiomyopathy (Takotsubo) – broken heart and mind? Vasc Health Risk Manag 2013; 9: 149–154. Dostupné z DOI: <http://dx.doi.org/10.2147/VHRM.S40163>.

30. Lee VH, Connolly HM, Fulgham JR et al. Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage: an underappreciated ventricular dysfunction. J Neurosurg 2006; 105(2): 264–270.

31. Ilio K, Sakurai S, Kato T et al. Endomyocardial biopsy in a patient with hemorrhagic pheochromocytoma presenting as inverted Takotsubo cardiomyopathy. Heart Vessels 2013; 28(2): 255–263.

32. Zielen P, Klisiewicz A, Januszewicz A et al. Pheochromocytoma-related “classic” takotsubo cardiomyopathy. J Hum Hypertens 2010;24(5): 363–366.

33. Redfors B, Shao Y, Omerovis E. Fatal stress-induced cardiomyopathy in a young patient treated with adrenomimetics. Clin Res Cardiol 2012; 101(11): 939–940.

Labels
Diabetology Endocrinology Internal medicine

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Internal Medicine

Issue 7-8

2015 Issue 7-8

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