Potential links between neurological disease and Tako-Tsubo cardiomyopathy: A literature review

Santoro, Francesco; Carapelle, Elena; Ortiz, Sofia Isabel Cieza; Musaico, Francesco; Ferraretti, Armando; D’Orsi, G.; Specchio, Luigi Maria; Biase, Matteo Di; Brunetti, Natale Daniele

doi:10.1016/j.ijcard.2013.03.093

Cited by 34 publications

(19 citation statements)

References 55 publications

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“…Angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers could have some benefit in term of improved survival at 1 year 3. β‐Blockers showed no effect on survival and recurrence rate,3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38 whereas calcium antagonists could be used if coronary vasospasm has been proven during coronary angiogram or with acetylcholine test 32…”

Section: Discussionmentioning

confidence: 97%

Left Ventricular Thrombi in Takotsubo Syndrome: Incidence, Predictors, and Management: Results From the GEIST (German Italian Stress Cardiomyopathy) Registry

Santoro

Stiermaier

Tarantino

et al. 2017

JAHA

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BackgroundLeft ventricular (LV) thrombi during Takotsubo syndrome represent a potential complication and can be associated with cerebrovascular embolic events. The aim of this study was to evaluate the exact incidence, predictors, and management strategies of LV thrombi in patients with Takotsubo syndrome.Methods and ResultsWe enrolled 541 consecutive patients in a multicenter international registry. Clinical features and echocardiographic data at admission, during hospitalization, and after 3 months were evaluated. Survival rates for long‐term follow‐up (mean 984±908 days) were recorded. Twelve Takotsubo syndrome patients (2.2%) developed LV thrombi (all female presenting with apical ballooning pattern). All patients with LV thrombi were treated with oral anticoagulation therapy; however, 2 (17%) had a stroke before treatment initiation. These patients were characterized by a higher prevalence of ST‐elevation (56% versus 16%; P<0.001) and higher troponin I levels (10.8±18.3 ng/mL versus 3.5±4.3 ng/mL; P=0.001) as compared with those without LV thrombi. At multivariate analysis including age, sex, LV ejection fraction, ST‐elevation at admission, and apical ballooning pattern, troponin I level >10 ng/mL was the only predictor for LV thrombosis (hazard ratio 6.6, confidence interval, 1.01–40.0; P=0.04). After 3 months all LV thrombi disappeared. Oral anticoagulation therapy was interrupted in all patients except 1. At long‐term follow‐up, the survival rate was not different between patients with and without LV thrombi (84% versus 85%; P=0.99).Conclusions LV thrombi have a relatively low incidence among patients with Takotsubo syndrome and were detected in female patients with apical ballooning pattern and increased troponin levels. Oral anticoagulation therapy for 3 months seems reasonable in these high‐risk patients.

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Section: Discussionmentioning

confidence: 97%

Left Ventricular Thrombi in Takotsubo Syndrome: Incidence, Predictors, and Management: Results From the GEIST (German Italian Stress Cardiomyopathy) Registry

Santoro

Stiermaier

Tarantino

et al. 2017

JAHA

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“…In addition, TTC developed several hours after ischemic stroke. 6 Combined with these findings, most patients with an unclear time sequence relationship might belong to the first group.…”

Section: Time Sequence Between Tmd and Strokementioning

confidence: 89%

“…2 Of the comorbidities, ischemic stroke has gained attention from clinicians because of the potential links between ischemic stroke and TTC. Currently, however, the information obtained from several anecdotal case series 4,5 and a wide-field approach 5,6 not focusing on ischemic stroke and considering ischemic stroke as one of the neurological diseases is limited and insufficient to determine a relationship between them. This is mainly derived considering that ischemic stroke itself could be a serious condition where invasive coronary angiography is difficult to get performed as a major diagnostic tool…”

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confidence: 99%

Takotsubo-Like Myocardial Dysfunction in Ischemic Stroke

Jung

Kim

et al. 2016

Stroke

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Background and Purpose-We investigated clinical and radiological characteristics of ischemic stroke patients with Takotsubo-like myocardial dysfunction. Methods-From multicenter stroke registry database, ischemic stroke patients who underwent transthoracic echocardiography were found. Among these, patients were classified if they had specific ventricular regional wall motion abnormalities discording with coronary artery distribution, such as apical (typical pattern) or nonapical ballooning (atypical pattern), considered as echocardiographic findings of Takotsubo cardiomyopathy. Patients with ischemic heart disease history, myocarditis, or pheochromocytoma were excluded. We compared patients with Takotsubo They had a higher inflammatory marker level and lower triglyceride level. Ischemic lesions were more commonly found in the right anterior circulation with specific dominant regions being the insula and peri-insular areas. In addition, a trend toward a remarkable mortality rate and higher prevalence of insular involvement was observed in the propensity-score matching, subgroup fulfilling the strict Takotsubo cardiomyopath criteria, and was as reported in literature review. Conclusion-Stroke patients with Takotsubo-like myocardial dysfunction may differ from those without in clinical outcomes, laboratory findings, and radiological features.

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“…Tako-Tsubo cardiomyopathy (TTC) is a recent medical entity mimicking acute coronary syndrome (ACS) and many articles have been published for a better knowledge [1][2][3][4][5][6]. Its incidence was uncertain and in a recent article published in the Journal [7], we have demonstrated that the annual incidence of TTC is estimated to be 29.8 per 1,000,000 inhabitants (95% CI: 18.6-44.9), 48.2 per 1,000,000 inhabitants (95% CI: 29.7-73.0) among women and 187.4 per 1,000,000 inhabitants (95% CI: 103.3-307.2) among women ≥60 years.…”

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confidence: 99%

“…Based on potential antiarrhythmic effects and potential antiarrhythmic effect, a role of fish oil in the prevention of AF has been postulated. However, the results from clinical studies have been conflicting, with some showing promising conclusions [6,9] and others yielding neutral results [3][4][5]7,8,10], and a definite role of fish oil in the setting of AF has not been demonstrated. Hence, we conducted a metaanalysis to evaluate the efficacy and safety of supplementation fish oil for the prevention of recurrent AF.…”

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confidence: 99%