Catecholamines May Play an Important Role in the Pathogenesis of Transient Mid- and Basal Ventricular Ballooning Syndrome

Kim, Eun‐Mi; Park, Jae‐Hyeong; Park, Yun Seon; Lee, Jae‐Hwan; Choi, Si Wan; Jeong, Jin‐Ok; Seong, In Whan

doi:10.3346/jkms.2008.23.5.898

Cited by 9 publications

(8 citation statements)

References 10 publications

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“…It distinguished by dysfunction of the basal and mid-ventricular segments with preserved function of the apical segments. Cases of inverted-Takotsubo cardiomyopathy associated with pheochromocytoma were also reported 20-22). Two of our cases showed inverted-Takotsubo cardiomyopathy which recovered completely within 3 days.…”

Section: Discussionsupporting

confidence: 64%

“…Cases of inverted-Takotsubo cardiomyopathy associated with pheochromocytoma were also reported. 20 - 22) Two of our cases showed inverted-Takotsubo cardiomyopathy which recovered completely within 3 days. The variations in segmental involvement regardless of coronary anatomy in patients with excessive catecholamine levels may suggest different susceptibility to sympathetic stimulation from individual to individual.…”

Section: Discussionmentioning

confidence: 61%

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Prevalence and Patterns of Left Ventricular Dysfunction in Patients with Pheochromocytoma

Park

Kim

Sul

et al. 2011

J Cardiovasc Ultrasound

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BackgroundExcessive catecholamine release in pheochromocytoma is known to cause transient reversible left ventricular (LV) dysfunction, such as in the case of pheochromocytoma-associated catecholamine cardiomyopathy. We investigated patterns of clinical presentation and incidence of LV dysfunction in patients with pheochromocytoma.MethodsFrom January 2004 to April 2011, consecutive patients with pheochromocytoma were retrospectively studied with clinical symptoms, serum catecholamine profiles, and radiologic findings. Patterns of electrocardiography and echocardiography were also analyzed.ResultsDuring the study period, a total of 36 patients (21 males, 49.8 ± 15.8 years, range 14-81 years) with pheochromocytoma were included. In the electrocardiographic examinations, normal findings were the most common findings (19, 52.8%). LV hypertrophy in 12 cases (33.3%), sinus tachycardia in 3 (8.3%), ischemic pattern in 1 (2.8%) and supraventricular tachycardia in 1 (2.8%). Echocardiographic exam was done in 29 patients (80.6%). Eighteen patients (62.1%) showed normal finding, 8 (27.6%) revealed concentric LV hypertrophy with normal LV systolic function, and 3 (10.3%) demonstrate LV systolic dysfunction (LV ejection fraction < 50%). Three showed transient LV dysfunction (2 with inverted Takotsubo-type cardiomyopathy and 1 with a diffuse hypokinesia pattern). Common presenting symptoms in the 3 cases were new onset chest discomfort and dyspnea which were not common in the other patients. Their echocardiographic abnormalities were normalized with conventional treatment within 3 days.ConclusionOut of total 36 patients with pheochromocytoma, 3 showed transient LV systolic dysfunction (catecholamine cardiomyopathy). Pheochromocytoma should be included as one of possible causes of transient LV systolic dysfunction.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 61%

Prevalence and Patterns of Left Ventricular Dysfunction in Patients with Pheochromocytoma

Park

Kim

Sul

et al. 2011

J Cardiovasc Ultrasound

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“…Consequently, 136 publications were included; 8 publications reported on more than one case report (from 2 to 7 cases; Figure ). Because of the extreme similarities between two reported pheochromocytoma‐induced TS cases, one case which was reported later was excluded . In total, 156 cases reports (107 cases with PPGL‐induced TS, 42 cases epinephrine‐induced TS, and 7 cases norepinephrine‐induced TS) constitute the patient cohort for the meta‐analysis.…”

Section: Resultsmentioning

confidence: 99%

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Y‐Hassan

Falhammar

2020

Clinical Cardiology

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Innumerable physical stress factors including externally administered catecholamines, and pheochromocytomas and paragangliomas (PPGLs) have been reported to trigger Takotsubo syndrome (TS). A systematic search of PubMed/MEDLINE identified 156 patients with catecholamine-induced TS up to December 2017. Data were compared within the catecholamine-induced TS cohort, but some comparisons were also done to a previously published large all-TS cohort (n = 1750). The mean age was 46.4 ± 16.4 years (72.3% women). The clinical presentation was dramatic with high complication rates in (68.2%, n = 103; multiple complications 34.6%, n = 54). The most common TS ballooning pattern was apical or mid-apical (45.2%, n = 69), followed by basal pattern (28.8%, n = 45), global pattern (16.0%, n = 25), midventricular (8.3%, n = 13), focal (0.6%, n = 1), and unidentified pattern (1.9%, n = 3).There was an increase in the prevalence of apical sparing ballooning pattern compared to all-TS population (37.7% vs 18.3%, P < .00001). Higher complication rates were observed in TS with global ballooning pattern compared to apical ballooning pattern (23/25, 92% vs 38/65, 58.5%; P = .0022). Higher complication rates were observed in patients with age < 50 years than patients >50 years (73/92, 79.3% vs 29/56, 51.8%, P = 0.0009). Recurrence occurred exclusively in patients with PPGLinduced TS (18/107 patients, 16.8%). PPGL-induced TS was characterized by more global ballooning's pattern (22/104, 21.2% vs 3/49, 6.1%, P = 0.02), and lower left ventricular ejection fraction (25.54 ± 11.3 vs 31.82 ± 9.93, P = 0.0072) compared to exogenous catecholamine-induced TS. In conclusion, catecholamine-induced TS was characterized by a dramatic clinical presentation with extensive left ventricular dysfunction, and high complication rate. K E Y W O R D S broken heart syndrome, epinephrine, myocardial stunning, norepinephrine, paraganglioma, pheochromocytoma, Takotsubo

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“…Subcutaneous injection of catecholamines and high dosage of some of sympathomimetic drugs, for example, methamphetamine, can cause catecholamine-induced cardiomyopathy 44)45). Pheochromocytoma is a well-known cause of catecholamine-induced cardiomyopathy 46)…”

Section: Reversible Cardiomyopathiesmentioning

confidence: 99%

“…However, variable types of SCMP can be associated with pheochromocytomas and iatrogenic catecholamine excess 44)47)…”

Section: Reversible Cardiomyopathiesmentioning

confidence: 99%

Role of Imaging in the Detection of Reversible Cardiomyopathy

Park

Kwon

Starling

et al. 2013

J Cardiovasc Ultrasound

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Heart failure is a major clinical problem in developed countries with about half of heart failure patients exhibiting decreased left ventricular systolic function. The correct identification and prompt treatment of some specific etiologies can reverse heart failure, and recognition of myocardial recovery may avoid long-term therapy. However, the echocardiographic patterns of patients with a variety of etiologies of heart failure are similar, so the selective use of other imaging techniques is necessary for identification of specific etiologies. The role of repeat imaging in monitoring the therapeutic response is controversial, as is the cessation of medical therapy in patients demonstrating recovery.

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Catecholamines May Play an Important Role in the Pathogenesis of Transient Mid- and Basal Ventricular Ballooning Syndrome

Cited by 9 publications

References 10 publications

Prevalence and Patterns of Left Ventricular Dysfunction in Patients with Pheochromocytoma

Prevalence and Patterns of Left Ventricular Dysfunction in Patients with Pheochromocytoma

Clinical features, complications, and outcomes of exogenous and endogenous catecholamine‐triggered Takotsubo syndrome: A systematic review and meta‐analysis of 156 published cases

Role of Imaging in the Detection of Reversible Cardiomyopathy

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