Neurogenic Stunned Myocardium: A Review

Stoddard, Amy; Lynch-Smith, Donna

doi:10.4037/aacnacc22021250

Cited by 4 publications

(6 citation statements)

References 28 publications

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“…29 Hence, NCD is an acute sympathetic cardiac shock which can be reversed with appropriate neuro-intensive care and treatment. 18 This study suggests that the overall impact on the quality of the organ transplant from an NCD event is small, although we did find a trend towards higher serum creatine in kidneys from donors with LV dysfunction. Studies on heart transplantation, in our own center and others, show similar findings with no effect on graft survival related to LV dysfunction in donors.…”

Section: Discussioncontrasting

confidence: 48%

“…However, NCD is not associated with coronary artery disease, and animal studies suggest that the pattern of myocardial necrosis occurring during this type of dysfunction correlate with the distribution of sympathetic nerve ends rather than coronary blood supply areas 29 . Hence, NCD is an acute sympathetic cardiac shock which can be reversed with appropriate neuro‐intensive care and treatment 18 . This study suggests that the overall impact on the quality of the organ transplant from an NCD event is small, although we did find a trend towards higher serum creatine in kidneys from donors with LV dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…7,10,[14][15][16] Acute LV dysfunction is relatively common in organ donors. It is likely secondary to the catecholamine surge that occurs with brain herniation, 17,18 but can also be due to myocardial stunning in donors following brain death due to cerebral oedema after cardiac arrest.…”

Section: Background and Aimmentioning

confidence: 99%

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Donor heart dysfunction and graft survival in liver and kidney transplants—A register‐based study from Sweden

Svensson,

Öberg,

Dellgren

et al. 2024

Clinical Transplantation

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Background and aimStress cardiomyopathy in donors can potentially affect graft function and longevity. This study aims to investigate the association between echocardiographic left ventricular ejection fraction (LVEF) < 50%, and/or the presence of left ventricular regional wall motion abnormalities (RWMA) in organ donors, and short‐ and long‐term liver and kidney graft survival. Our secondary aim was to link graft survival with donor and recipient characteristics.MethodsAll donors considered for liver and kidney donation with echocardiographic records at Sahlgrenska University Hospital between 2006 and 2016 were matched with their recipients through the Scandiatransplant register. The studied outcomes were graft survival, re‐transplantation, and recipient death. Kaplan–Meier curves were used to plot time to event. Multivariate Cox‐regression was used to test independence.ResultsThere were 370 liver donors and 312 kidney donors (matched with 458 recipients) with echocardiographic records at Sahlgrenska University Hospital between June 2006 and November 2016. Of patients with LV dysfunction by echocardiography, there were 102 liver‐ and 72 kidney donors. Univariate survival analyses showed no statistical difference in the short‐ and long‐term graft survival from donors with LV dysfunction compared to donors without. Donor age > 65 years, recipient re‐transplantation and recipient liver tumor were predictors of worse outcome in liver transplants (p < .05). Donor age > 65, donor hypertension, recipient re‐transplantation, and a recipient diagnosis of diabetes or nephritis/glomerulonephritis had a negative association with graft survival in kidney transplants (p < .05).ConclusionWe found no significant association between donor LV dysfunction and short‐ and long‐term graft survival in liver and kidney transplants, suggesting that livers and kidneys from such donors can be safely transplanted.

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Section: Discussioncontrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

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Donor heart dysfunction and graft survival in liver and kidney transplants—A register‐based study from Sweden

Svensson,

Öberg,

Dellgren

et al. 2024

Clinical Transplantation

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“…While the underlying pathophysiology of Takotsubo cardiomyopathy and its variants is unknown, it is thought that sympathetic hyperactivity plays a pivotal role, resulting in vasospasm, microvascular dysfunction, and direct cardiotoxicity [3,4]. A recent Japanese study described an increased rate of Takotsubo cardiomyopathy among patients on prescribed intravenous adrenergic agents, and case reports have shown an association with neurogenic causes as well as amphetamine use [5][6][7]. Animal model research links circulating microRNAs associated with anxiety and depression to reduced myocardial contractility when exposed to adrenergic agents, suggesting that these may be predisposing factors in Takotsubo cardiomyopathy development [8].…”

Section: Discussionmentioning

confidence: 99%

Reverse Takotsubo Cardiomyopathy After Accidental Exposure to an Illicit Substance: A Case Report

White¹,

Jeanmonod²

2022

Cureus

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Stress-induced (Takotsubo) cardiomyopathy is a clinical syndrome and its incidence has been on the rise. Patients with this syndrome often present with chest pain, dyspnea, or syncope. The findings from a typical cardiac evaluation can make this entity difficult to distinguish from acute myocardial infarction (AMI).A 50-year-old woman presented to the emergency department (ED) with anxiety and palpitations after the accidental ingestion of a sympathomimetic. The patient had consumed coffee that she had brewed in a hotel coffee pot, unaware that a previous guest had placed drug paraphernalia including methamphetamine in the water reservoir of the coffee pot. Her symptoms had started shortly thereafter. In the ED, the patient's workup was remarkable for positive troponin and an echocardiogram demonstrating basilar hypokinesis. The patient's ejection fraction was reduced at 40%. She was admitted to the hospital, where she underwent catheterization, demonstrating normal coronary arteries. She had full clinical recovery at the sixmonth follow-up.Reverse Takotsubo cardiomyopathy is a rare variant of Takotsubo cardiomyopathy, which presents with basal left ventricular hypokinesis. It is associated with younger age and female gender and has an overall good prognosis. This diagnosis should be considered in patients who are otherwise at low risk for atherosclerotic cardiac disease with known emotional or physical triggers and changes in left ventricular function. Treatment is generally supportive, but a Takotsubo cardiomyopathy diagnosis alters the management of shock and dysrhythmia when known.

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“…Ein neurogenes myokardiales Stunning präsentiert sich ähnlich wie ein Tako-Tsubo-Syndrom und geht ebenfalls mit einer reversiblen Ventrikeldysfunktion einher. Es kann bei Patientinnen und Patienten mit einer intrazerebralen Hämorrhagie oder einem akuten Schädel-Hirn-Trauma auftreten [18,19,20]. ▪ Ionenkanalerkrankungen: Obwohl Ionenkanalerkrankungen und Kardiomyopathien gehäuft in einen kausalen Zusammenhang gebracht werden, erachtet die Task-Force dieser Leitlinie die aktuelle Evidenz zu diesem Thema nicht als ausreichend, um Kanalopathien als Kardiomyopathien zu betrachten [1,2].…”

Section: Kardiomyopathie-phänotypenunclassified

Phänotypische Klassifizierung der Kardiomyopathien entsprechend den Leitlinien der ESC 2023

Olic,

Bäßler,

Maier

2024

Aktuelle Kardiologie

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ZusammenfassungKardiomyopathien sind Herzmuskelerkrankungen mit struktureller und funktioneller Myokardstörung. Die ESC hat 2023 erstmals eine internationale Leitlinie zum gesamten Spektrum der Kardiomyopathien herausgebracht. Ein zentrales Element der Leitlinie ist die phänotypische Klassifizierung der Kardiomyopathien. Hierbei spielt neben morphologischen und funktionellen Merkmalen als wesentliche Neuerung auch die genaue Gewebecharakterisierung (z. B. Narbenbildung) basierend auf einer kardialen Magnetresonanztomografie (CMR) eine wesentliche Rolle. Auf dieser Grundlage erfolgt die phänotypische Einteilung in 5 Hauptformen. Zusätzlich zur dilatativen, hypertrophen und restriktiven Kardiomyopathie (DCM, HCM und RCM) wurde die nicht dilatierte linksventrikuläre Kardiomyopathie (NDLVC) neu definiert. Ferner wurde die Gruppe der arrhythmogenen rechtsventrikulären Kardiomyopathie (ARVC) aktualisiert. Die hiermit definierten Kardiomyopathie-Phänotypen sollen die Ermittlung der genauen Ätiologie vereinfachen.

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Neurogenic Stunned Myocardium: A Review

Cited by 4 publications

References 28 publications

Donor heart dysfunction and graft survival in liver and kidney transplants—A register‐based study from Sweden

Donor heart dysfunction and graft survival in liver and kidney transplants—A register‐based study from Sweden

Reverse Takotsubo Cardiomyopathy After Accidental Exposure to an Illicit Substance: A Case Report

Phänotypische Klassifizierung der Kardiomyopathien entsprechend den Leitlinien der ESC 2023

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