Impaired hemodynamic response to tilt, handgrip and Valsalva manoeuvre in patients with takotsubo syndrome.

Autor: Stępniewska A; Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland., Budnik M; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland. Electronic address: moni.budnik@gmail.com., Krzemiński K; Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Niewiadomski W; Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland., Gąsiorowska A; Department of Applied Physiology, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland., Opolski G; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Kochanowski J; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Mieczkowska K; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Żukowska K; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Szepietowska K; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland., Kowalik R; 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
Jazyk: angličtina
Zdroj: Autonomic neuroscience : basic & clinical [Auton Neurosci] 2019 Sep; Vol. 220, pp. 102555. Date of Electronic Publication: 2019 Jun 03.
DOI: 10.1016/j.autneu.2019.102555
Abstrakt: Purpose: Long-term β-adrenolytics treatment in takotsubo syndrome (TTS) patients is based on the premise, that TTS is strongly associated with sympathetic nervous system overactivity. The aim of the study was to establish hemodynamic response to tilt, handgrip and Valsalva manoeuvre in patients with takotsubo syndrome compared to healthy subjects (CONTROL) and patients after ST Elevation Myocardial Infarction (STEMI).
Material and Method: Echocardiographic examination was performed at rest, ECG and continuously non-invasively measured arterial blood pressure were used for evaluation of hemodynamic responses to Valsalva manoeuvre, static handgrip (HG) followed by post-exercise ischemia, and tilt. Ten healthy women, 20 with TTS and 20 after STEMI, mean age 64 ± 8.5 years, participated in the study.
Results: Pressor response to Valsalva manoeuvre and tilt in TTS group was diminished in comparison to CONTROL and close to that of STEMI. During HG, increase of SBP was the lowest in TTS group. Data indirectly suggest that it was due to deficient stroke volume in TTS and STEMI patients during these manoeuvres; though echocardiographic findings at rest did not reveal any significant differences between groups.
Conclusions: Our data show that despite apparent resolution of the immediate effects of TTS, impaired response to cardiovascular challenge, similar to that in STEMI patients, persisted. As the manoeuvres applied mimic daily life situations, causes of impairment should be searched for and potential health risk evaluated.
(Copyright © 2019 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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