Unraveling the mechanisms underlying Takotsubo (TTS) leads to question the current inclusion of the condition within the spectrum of cardiomyopathies. Indeed, the clinical presentation and pathophysiology of TTS clearly differ from cardiomyopathies, i.e. diseases of heart muscle unexplained by abnormal loading conditions or coronary artery disease, which cannot recover spontaneously and may cause sudden death often in minimally symptomatic individuals or result in a gradual deterioration in ventricular function and end-stage heart failure. Furthermore, the term âcardiomyopathyâ can no longer be applied when functional or morphologic abnormalities of the coronary arteries leading to acute myocardial ischemia are deemed responsible for left ventricular (LV) systolic dysfunction. After 27 years of investigation, time has come to recognize that patients with TTS do suffer from severe myocardial ischemia and fulfill all criteria of acute coronary syndromes, i.e. acute chest pain, typical electrocardiographic changes, cardiac troponin rise, as well as LV wall motion abnormalities. Accordingly, we propose that TTS should be labeled as an acute âsyndromeâ to be included more appropriately within the spectrum of ischemic heart disease. With regard to the term âstressâ it may imply that the catecholamine surge is essential to produce the typical transient myocardial injury. Thus, the terminology âTakotsubo (stress) syndromeâ would more accurately reflect recent advances in the pathophysiology.
Takotsubo is not a cardiomyopathy / Pelliccia, Francesco; Sinagra, Gianfranco; Elliott, Perry; Parodi, Guido; Basso, Cristina; Camici, Paolo G.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 254:(2018), pp. 250-253. [10.1016/j.ijcard.2017.12.009]
Takotsubo is not a cardiomyopathy
Camici, Paolo G.
2018-01-01
Abstract
Unraveling the mechanisms underlying Takotsubo (TTS) leads to question the current inclusion of the condition within the spectrum of cardiomyopathies. Indeed, the clinical presentation and pathophysiology of TTS clearly differ from cardiomyopathies, i.e. diseases of heart muscle unexplained by abnormal loading conditions or coronary artery disease, which cannot recover spontaneously and may cause sudden death often in minimally symptomatic individuals or result in a gradual deterioration in ventricular function and end-stage heart failure. Furthermore, the term âcardiomyopathyâ can no longer be applied when functional or morphologic abnormalities of the coronary arteries leading to acute myocardial ischemia are deemed responsible for left ventricular (LV) systolic dysfunction. After 27 years of investigation, time has come to recognize that patients with TTS do suffer from severe myocardial ischemia and fulfill all criteria of acute coronary syndromes, i.e. acute chest pain, typical electrocardiographic changes, cardiac troponin rise, as well as LV wall motion abnormalities. Accordingly, we propose that TTS should be labeled as an acute âsyndromeâ to be included more appropriately within the spectrum of ischemic heart disease. With regard to the term âstressâ it may imply that the catecholamine surge is essential to produce the typical transient myocardial injury. Thus, the terminology âTakotsubo (stress) syndromeâ would more accurately reflect recent advances in the pathophysiology.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.