Tako-tsubo cardiomyopathy and coronary artery disease

Parodi, Guido; Citro, Rodolfo; Bellandi, Benedetta; Pace, Stefano Del; Rigo, Fausto; Marrani, Marco; Provenza, Gennaro; Leoncini, Mario; Uriarte, Joerge A. Salerno; Bovenzi, Francesco; Bossone, Eduardo

doi:10.1097/mca.0b013e3283645c4e

Cited by 54 publications

(37 citation statements)

References 15 publications

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“…This finding shows that the presence of coronary artery disease is not an exclusion criterion for the diagnosis of takotsubo cardiomyopathy. 13,29 Takotsubo cardiomyopathy should be considered to be an acute heart failure syndrome, as reflected by the markedly increased levels of brain natriuretic peptide and left ventricular end-diastolic pressure. Consistently, systolic left ventricular function was reduced to an even greater extent among patients with takotsubo cardiomyopathy than among those with an acute coronary syndrome.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Templin¹,

et al. 2015

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BACKGROUND The natural history, management, and outcome of takotsubo (stress) cardiomyopathy are incompletely understood. METHODS The International Takotsubo Registry, a consortium of 26 centers in Europe and the United States, was established to investigate clinical features, prognostic predictors, and outcome of takotsubo cardiomyopathy. Patients were compared with age-and sex-matched patients who had an acute coronary syndrome. RESULTS Of 1750 patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Among patients with takotsubo cardiomyopathy, as compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%) (P<0.001 for both comparisons). Rates of severe in-hospital complications including shock and death were similar in the two groups (P=0.93). Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year. CONCLUSIONS Patients with takotsubo cardiomyopathy had a higher prevalence of neurologic or psychiatric disorders than did those with an acute coronary syndrome. This condition represents an acute heart failure syndrome with substantial morbidity and mortality. (Funded by the Mach-Gaensslen Foundation and others; ClinicalTrials.gov number, NCT01947621.).

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Section: Discussionmentioning

confidence: 99%

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Templin¹,

et al. 2015

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“…However, in the revised Mayo Clinic diagnostic criteria for TTC, the presence of CAD in vessels not supplying dysfunctional myocardium is no longer an exclusion criterion to establish the diagnosis [3]. According to recent reports, the prevalence of various degrees of CAD in patients with TTC ranged from 10 to 60 % [1,4,5]. This increased recognition of the coexistence of CAD and TTC, however, comprises diagnostic and therapeutic challenges.…”

Section: Sirsmentioning

confidence: 89%

“…A multi-center registry including 450 patients reported additional relevant CAD (stenosis [50 %) in up to 10 % of TTC patients. However, CAD was present in coronary vessels not supplying the dysfunctional myocardium [5]. The currently largest registry including 1750 TTC patients showed CAD in 15 % of all cases [1].…”

Section: Sirsmentioning

confidence: 98%

Classical apical ballooning with significant stenosis of the left anterior descending coronary artery: is cardiac magnetic resonance imaging the solution for this diagnostic dilemma?

et al. 2016

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“…Parodi et al (9) noted that, nearly one-tenth of patients had at least one relevant (≥50%) coronary stenosis without supplying the dysfunctional myocardium, whereas nearly 90% patients had irrelevant stenosis or angiographically normal coronary arteries. Thus, when the stenotic artery does not supply the involved (dysfunctional) myocardium or when the extent of dysfunctional myocardium is larger than the area supplied by a single stenotic coronary artery, the presence of angiographically relevant coronary artery disease should be accepted as an exclusion criterion for TS.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo Syndrome and Acute Coronary Syndrome: Case Report and Literature Review

Yaylacı¹,

Öztürk²,

Serinken³

et al. 2015

JAEM

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Takotsubo syndrome (TS) has been described as an acute cardiac condition precipitated by a stressful mental or physical condition. A majority of patients are presented with acute substernal chest pain. It is often difficult to differentiate TS from acute ST-elevation myocardial infarction (STEMI) on initial presentation. The electrocardiograph classically mimics STEMI and is generally accompanied by elevation of myocardial enzymes that warrants immediate cardiac catheterization. The present article reports a patient with TS referred to the emergency department because of symptoms suggestive of acute coronary syndrome. (JAEM 2015; 14: 41-3)

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Tako-tsubo cardiomyopathy and coronary artery disease

Cited by 54 publications

References 15 publications

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy

Classical apical ballooning with significant stenosis of the left anterior descending coronary artery: is cardiac magnetic resonance imaging the solution for this diagnostic dilemma?

Takotsubo Syndrome and Acute Coronary Syndrome: Case Report and Literature Review

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