Deep Negative T Waves and Abnormal Cardiac Sympathetic Image(123I-MIBG) After the Great Hanshin Earthquake of 1995

Yagi, Hiroshi; Hanaoka, Junichi; Funakoshi, Takahiro; Iwahashi, Masanori; Takeuchi, Motoshi; Saito, Komei; Kawashima, Seinosuke; Yokoyama, Mitsuhiro

doi:10.1097/00000441-199605000-00005

Cited by 11 publications

(5 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Japan, after the Hanshin–Awaji earthquake, Yamabe et al [30] observed an increase in the incidence of patients with deep negative T waves. In a rat model, activation of cardiac adrenoceptors by psychological stress causes similar ECG changes [24,31,32].…”

Section: Discussionmentioning

confidence: 99%

Reversible ventricular dysfunction takotsubo cardiomyopathy

Akashi

Musha

Kida

et al. 2005

European J of Heart Fail

View full text Add to dashboard Cite

Background: Recently, many cardiologists have recognized the existence of a rapidly reversible form of heart failure of unknown origin characterized by a takotsubo-shaped, dyskinetic left ventricle on left ventriculography. Aim: To determine the detailed clinical features of takotsubo cardiomyopathy. Methods: Thirteen elderly patients (11 women and 2 men with a mean age of 75.3 years) who had normal coronary arteries and takotsubolike left ventricular dysfunction were prospectively enrolled in this study. Results: Cardiac enzymes did not increase significantly, but the mean plasma norepinephrine level was very high on admission (0.98 Ag/l). Coronary angiography revealed normal coronary arteries in all patients, but left ventriculography showed apical akinesis combined with basal hyperkinesis, i.e., a takotsubo (Japanese octopus fishing pot)-shaped ventricle. Left ventricular wall motion normalized within a mean of 16.9 hospital days in 12 patients, but 1 patient died of acute renal failure on hospital day 7. Cardiac events did not recur during a follow-up period of 0.5 to 5 years. Conclusion: Takotsubo cardiomyopathy seems to be a new type of acute heart failure, which generally has a good prognosis and does not recur. Myocardial damage by catecholamine overload, adrenoceptor hypersensitivity, and changes of catecholamine dynamics due to stress may cause this condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Reversible ventricular dysfunction takotsubo cardiomyopathy

Akashi

Musha

Kida

et al. 2005

European J of Heart Fail

View full text Add to dashboard Cite

show abstract

“…Heart rate and the ratio of low frequency/high frequency (LF/HF) power increased after the earthquake and were attributed to PNS withdrawal [ 112 ]. After the Great Hanshin Earthquake of 1995, there was an increased frequency of deep negative electrocardiographic T waves and accelerated washout of cardiac 123 I-metaiodobenzylguanidine-derived radioactivity, interpreted as indicating increased cardiac sympathetic outflow [ 196 ]. The 2008 Sichuan earthquake was associated with an increased frequency of hemodynamically unstable ventricular tachyarrhythmias [ 202 ].…”

Section: The Eas and Biomarkers Of Risk With Applications To Covid-1mentioning

confidence: 99%

“…Both patients had accelerated loss of 123 I-metaiodobenzylguanidine-( 123 I-MIBG)-derived radioactivity, consistent with increased sympathetically mediated exocytosis from myocardial sympathetic nerves. After the 1995 Hanshin earthquake, there was an increased incidence of patients with deep negative T waves, also associated with accelerated loss of 123 I-MIBG-derived radioactivity [ 196 ]. After the 2011 East Japanese earthquake/tsunami there was an increased incidence of acute decompensated heart failure in the affected geographic region [ 127 ].…”

Section: The Eas and Biomarkers Of Risk With Applications To Covid-1mentioning

confidence: 99%

The extended autonomic system, dyshomeostasis, and COVID-19

2020

View full text Add to dashboard Cite

The pandemic viral illness COVID-19 is especially life-threatening in the elderly and in those with any of a variety of chronic medical conditions. This essay explores the possibility that the heightened risk may involve activation of the "extended autonomic system" (EAS). Traditionally, the autonomic nervous system has been viewed as consisting of the sympathetic nervous system, the parasympathetic nervous system, and the enteric nervous system. Over the past century, however, neuroendocrine and neuroimmune systems have come to the fore, justifying expansion of the meaning of "autonomic." Additional facets include the sympathetic adrenergic system, for which adrenaline is the key effector; the hypothalamic-pituitary-adrenocortical axis; arginine vasopressin (synonymous with anti-diuretic hormone); the renin-angiotensin-aldosterone system, with angiotensin II and aldosterone the main effectors; and cholinergic anti-inflammatory and sympathetic inflammasomal pathways. A hierarchical brain network-the "central autonomic network"-regulates these systems; embedded within it are components of the Chrousos/Gold "stress system." Acute, coordinated alterations in homeostatic settings (allostasis) can be crucial for surviving stressors such as traumatic hemorrhage, asphyxiation, and sepsis, which throughout human evolution have threatened homeostasis; however, intense or long-term EAS activation may cause harm. While required for appropriate responses in emergencies, EAS activation in the setting of chronically decreased homeostatic efficiencies (dyshomeostasis) may reduce thresholds for induction of destabilizing, lethal vicious cycles. Testable hypotheses derived from these concepts are that biomarkers of EAS activation correlate with clinical and pathophysiologic data and predict outcome in COVID-19 and that treatments targeting specific abnormalities identified in individual patients may be beneficial.

show abstract

“…In many cases, presentation occurs shortly after an episode of high emotional or physical stress. For example, an increased incidence of the syndrome was noticed after earthquakes in Japan 19 20. Given that catecholamine values are likely to be elevated during this type of presentation, the question is whether there is evidence that the activity of the catecholamine sympathetic nervous system is abnormal in TC.…”

Section: Pathophysiologymentioning

confidence: 99%

Takotsubo cardiomyopathy: a diagnostic challenge

Zeb

Sambu

Scott

et al. 2010

Postgraduate Medical Journal

View full text Add to dashboard Cite

The frequency of the diagnosis of takotsubo cardiomyopathy has increased rapidly over the past few years, possibly due to increasing awareness among cardiologists. At initial presentation the diagnosis remains a challenge because of the close similarity between the presentation of takotsubo cardiomyopathy, and that of ST elevation myocardial infarction (STEMI). Recognition of salient aspects of the medical history at presentation are important in order to organise further appropriate investigations such as echocardiography and left ventriculography at the time of coronary angiogram. Takotsubo cardiomyopathy can be easily missed without ventriculography early after presentation because of the transient nature of left ventricular dysfunction, and in many centres left ventriculogram is not done as standard in the setting of STEMI. The authors advocate left ventriculography in all cases of ST elevation who have unobstructed coronaries. The correct diagnosis of takotsubo cardiomyopathy is very important for future advice and management of the patient. The prognosis of this condition is generally excellent with almost all patients returning to normal within a few weeks. This article examines the takotsubo cardiomyopathy literature and discusses the pathophysiology, clinical features, management, and prognosis of this condition in the context of an illustrated case.

show abstract

Deep Negative T Waves and Abnormal Cardiac Sympathetic Image(123I-MIBG) After the Great Hanshin Earthquake of 1995

Cited by 11 publications

References 15 publications

Reversible ventricular dysfunction takotsubo cardiomyopathy

Reversible ventricular dysfunction takotsubo cardiomyopathy

The extended autonomic system, dyshomeostasis, and COVID-19

Takotsubo cardiomyopathy: a diagnostic challenge

Contact Info

Product

Resources

About