2021
DOI: 10.3389/fcvm.2021.732708
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Oxidative Stress in Takotsubo Syndrome—Is It Essential for an Acute Attack? Indirect Evidences Support Multisite Impact Including the Calcium Overload—Energy Failure Hypothesis

Abstract: Indirect evidences in reviews and case reports on Takotsubo syndrome (TTS) support the fact that the existence of oxidative stress (OS) might be its common feature in the pre-acute stage. The sources of OS are exogenous (environmental factors including pharmacological and toxic influences) and endogenous, the combination of both may be present, and they are being discussed in detail. OS is associated with several pathological conditions representing TTS comorbidities and triggers. The dominant source of OS ele… Show more

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Cited by 12 publications
(5 citation statements)
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References 238 publications
(406 reference statements)
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“…Administration of β-adrenergic agonists, such as isoprenaline, can induce clinical symptoms and signs of TTS [ 28 ]. An excess of catecholamines can induce oxidative stress and inflammation, suggesting their involvement in the pathophysiology of TTS [ 31 ].…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Administration of β-adrenergic agonists, such as isoprenaline, can induce clinical symptoms and signs of TTS [ 28 ]. An excess of catecholamines can induce oxidative stress and inflammation, suggesting their involvement in the pathophysiology of TTS [ 31 ].…”
Section: Discussionmentioning
confidence: 99%
“…Second, because of the excess of catecholamines in patients with TTS, adrenalin can also be used to induce TTS in animals [ 61 ]. At the same time, in animal models, isoprenaline is also used because its effects are more limited to the heart [ 4 , 12 , 32 , 58 ], and isoprenaline causes similar pathophysiological features as TTS [ 12 , 31 ]. Third, although in this experiment the apical akinesia characteristic for TTS was not demonstrated, Sachdeva et al [ 11 ] documented it after using the same dose and the same time sequence of isoprenaline administration used in this study.…”
Section: Discussionmentioning
confidence: 99%
“…“Challengers” include salts of various metals (iron, chromium, aluminium, titanium and lead), as well as corticosteroids and immunosuppressants [ 30 ]. A common feature of these substances may be the production of oxidative stress [ 31 ]. Another mechanism of metal-induced inflammation represents the delayed type of hypersensitivity reactions demonstrated in systemic connective tissue diseases and in dilated cardiomyopathy [ 16 , 17 , 32 ].…”
Section: Discussionmentioning
confidence: 99%
“…Catecholamines can cause direct myocardial cell toxicity damage by a sudden influx and impaired clearance of intracellular calcium which results in prolonged contraction and ATP depletion, an effect termed “catecholamine toxicity” [ 24 ]. Calcium overload, oxidative stress and mitochondrial dysfunction are all possible mechanisms implicated in the cardiotoxicity, leading to myocardial injury and cellular necrosis [ 25 ]. Furthermore, the increased metabolic demand, due to increased heart rate and cardiac contraction, and the reduced blood and oxygen supply, due to vasoconstriction and vasospasm, further raise the risk of ischemic events and cell death [ 26 ].…”
Section: Physiopathologymentioning
confidence: 99%