A systematic review of biomarkers in Takotsubo syndrome: A focus on better understanding the pathophysiology

Khan, Hilal; Gamble, David; Mezincescu, Alice; Abbas, Hassan; Rudd, Amelia; Dawson, Dana

doi:10.1016/j.ijcha.2021.100795

Cited by 17 publications

(21 citation statements)

References 35 publications

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“…Troponin values usually peak within 24 hours and natriuretic peptide just after 48 hours. Khan et al conducted a meta-analysis about the issue, which found an elevated natriuretic peptide/troponin ratio [15], compatible with our case presentation [2]. Wall motion abnormalities detection is achieved through echocardiographic evaluation, which has become the first method of choice.…”

Section: Discussionsupporting

confidence: 80%

Reverse Takotsubo Cardiomyopathy During Immediate Post-partum: A Case Report

Sánchez-Amaya¹,

Lopez-Lizarraga²,

Castañeda³

et al. 2023

Cureus

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Takotsubo cardiomyopathy or stress-induced cardiomyopathy is a particular entity with a transient left ventricular dysfunction without significant coronary artery obstruction, preceded by a stressful circumstance. Clinical presentation may mimic myocardial infarction, acute heart failure among the most common conditions. If suspected, the integration of clinical aspects, imaging results, and laboratory tests allows its diagnosis and proper management. Once described as a post-menopausal women's disease, is now recognized as a more frequent condition of young women, especially after stressful conditions such as postsurgical status and peripartum period, rendering as a disease with a certain predisposition to female patients, with a not always benign evolution. This case remarks an atypical presentation experiencing a first nigh fatal evolution but a later satisfactory recuperation.

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Section: Discussionsupporting

confidence: 80%

Reverse Takotsubo Cardiomyopathy During Immediate Post-partum: A Case Report

Sánchez-Amaya¹,

Lopez-Lizarraga²,

Castañeda³

et al. 2023

Cureus

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“…The release of NT-proBNP is associated with the degree of LV wall stress while hs-cTnT is a marker of myocardial injury. Thus, a worse myocardial contractility during the acute phase of TTS would favor a higher release of both cardiac biomarkers (33)(34)(35). On the other hand, although we did not nd a signi cant correlation between NH-IMRangio and GLS values, we observed a trend towards worse GLS values in those patients with less impaired MR, suggesting that ventricular dysfunction in TTS patients may not be only due to myocardial damage.…”

Section: Discussioncontrasting

confidence: 70%

Incremental prognostic value of global longitudinal strain to the coronary microvascular resistances in Takotsubo patients

Sans‐Roselló

Fernández-Peregrina

Durán-Cambra

et al. 2022

Int J Cardiovasc Imaging

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Background: Global longitudinal strain (GLS) allows an accurate assessment of left ventricular function with prognostic value. We aimed to evaluate whether the assessment of GLS in the acute phase of Takotsubo syndrome (TTS) provides incremental prognostic value to the degree of impaired microvascular resistance (MR) in TTS patients at 1-year follow-up.Methods: We recruited 78 consecutive patients admitted for TTS who underwent cardiac angiography and echocardiography from January 2017 to June 2021. Left anterior descending coronary artery nonhyperaemic angiography-derived index of microcirculatory resistance (LAD NH-IMRangio) was calculated.NT-proBNP, high-sensitive cardiac troponin T (hs-cTnT), left ventricular ejection fraction (LVEF) and GLS were measured at admission. Major adverse cardiac events (MACE) were de ned as the composite of cardiovascular death, heart failure (HF) events, symptomatic arrythmias and acute myocardial infarctions.Results: 67 patients had both GLS and NH-IMRangio available. Median age was 75.2 years and 88 % were women. Rate of MACE at 1-year was 23.9% mainly due to mild HF events. Kaplan-Meier curves showed higher rates of MACE at 1-year in patients with both higher LAD NH-IMRangio and GLS values compared with those with higher LAD NH-IMRangio and lower GLS values (60.0% vs 22.2%; p=0.0373).NT-proBNP levels at admission and the recovery of LVEF were correlated with GLS values while MR and hs-cTnT were not.Conclusions: GLS provides incremental prognostic value to the degree of impaired MR in TTS patients.The combination of a poorer GLS with a higher degree of impaired MR was associated with a higher rate of MACE in these patients.

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“…Notably, a recently published retrospective study showed that the presence of LBBB was associated with ventricular arrhythmias occurring in patients with TTS, thus suggesting a possible value of LBBB in the prognosis of this population [36] . In addition to the low sensitivity of ECG, there is a lack of diagnostic biomarkers that can discriminate patients with TTS from those with AMI, thereby allowing clinical monitoring and providing prognostic information in the long term [37] . In contrast, echocardiography is essential in visualizing wall motion abnormalities extending beyond the territory of the involved coronary artery, which is the main feature of TTS.…”

Section: Takotsubo Syndromementioning

confidence: 99%