Takotsubo Syndrome: Finally Emerging From the Shadows?
| Autor: | Thanh H Nguyen, Sven Y. Surikow, Karin Schenck-Gustafsson, Yuliy Y. Chirkov, Cher-Rin Chong, Angela M Kucia, Michael P. Frenneaux, Gao Jing Ong, Olivia Girolamo, Saifei Liu, John D. Horowitz |
|---|---|
| Přispěvatelé: | Ong, Gao Jing, Nguyen, Thanh Ha, Kucia, Angela, Liu, Sai Fei, Surikow, Sven Y., Girolamo, Olivia, Chong, Cher Rin, Chirkov, Yuliy Y., Schenck-Gustafsson, Karin, Frenneaux, Michael P., Horowitz, John D. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty 2019-20 coronavirus outbreak Coronavirus disease 2019 (COVID-19) Mri imaging Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Heart Ventricles cardiac magnetic resonance imaging Magnetic Resonance Imaging Cine 030204 cardiovascular system & hematology Ventricular Function Left 03 medical and health sciences 0302 clinical medicine Cardiac magnetic resonance imaging Takotsubo Cardiomyopathy Internal medicine medicine Humans 030212 general & internal medicine Takotsubo syndrome medicine.diagnostic_test business.industry nitrosative stress medicine.anatomical_structure Cardiology business Cardiology and Cardiovascular Medicine Artery |
| Zdroj: | Heart, Lung and Circulation |
| ISSN: | 1443-9506 |
| DOI: | 10.1016/j.hlc.2020.10.006 |
| Popis: | It is now 30 years since Japanese investigators first described Takotsubo Syndrome (TTS) as a disorder occurring mainly in ageing women, ascribing it to the impact of multivessel coronary artery spasm. During the intervening period, it has become clear that TTS involves relatively transient vascular injury, followed by prolonged myocardial inflammatory and eventually fibrotic changes. Hence symptomatic recovery is generally slow, currently an under-recognised issue. It appears that TTS is induced by aberrant post-β2-adrenoceptor signalling in the setting of “surge” release of catecholamines. Resultant activation of nitric oxide synthases and increased inflammatory vascular permeation lead to prolonged myocardial infiltration with macrophages and associated oedema formation. Initially, the diagnosis of TTS was made via exclusion of relevant coronary artery stenoses, plus the presence of regional left ventricular hypokinesis. However, detection of extensive myocardial oedema on cardiac MRI imaging offers a specific basis for diagnosis. No adequate methods are yet available for definitive diagnosis of TTS at hospital presentation. Other major challenges remaining in this area include understanding of the recently demonstrated association between TTS and antecedent cancer, the development of effective treatments to reduce risk of short-term (generally due to shock) and long-term mortality, and also to accelerate symptomatic recovery. Refereed/Peer-reviewed |
| Databáze: | OpenAIRE |
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