Review
Medicine, General & Internal
Yashendra Sethi, Hamsa Murli, Oroshay Kaiwan, Vidhi Vora, Pratik Agarwal, Hitesh Chopra, Inderbir Padda, Manasa Kanithi, Mihaela Simona Popoviciu, Simona Cavalu
Summary: Broken Heart Syndrome, also known as Takotsubo Syndrome (TS), is a sudden and transient dysfunction of the left and/or right ventricle, often resembling Acute Coronary Syndrome (ACS). It was first described in Japan in the 1990s and has since gained attention from researchers worldwide. Recent evidence suggests that TS may have serious complications and mortality rates similar to ACS. The exact etiology of TS is still poorly understood, but it can be classified into primary and secondary types. Primary TS occurs due to symptoms of myocardial damage preceded by emotional stress, while secondary TS occurs as a complication of other medical conditions. Pathophysiological mechanisms include adrenergic hormones/stress, decreased estrogen levels, altered microcirculation, and disturbances in the brain-heart axis. More research is needed to understand the molecular mechanisms and develop individualized treatments for TS.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Michiaki Nagai, Sergey Shityakov, Manuel Smetak, Hannah Jill Hunkler, Christian Baer, Nicolas Schlegel, Thomas Thum, Carola Yvette Foerster
Summary: Takotsubo syndrome (TTS), characterized by transient wall motion abnormalities of the left ventricle, presents challenges in diagnosis. A comprehensive blood analysis of TTS patients revealed differences in proinflammatory cytokine expression patterns and receptor expression levels. Surprisingly, catecholamine levels in TTS patients were significantly lower than experimentally induced TTS in animals, and exposure to these lower levels did not damage endothelial cells or cardiomyocytes in vitro. Computational analysis identified blood markers and microRNAs associated with TTS development and inflammation. In addition to known risk factors, inflammaging-related pathways were found to contribute to TTS.
Review
Cardiac & Cardiovascular Systems
Anthony Matta, Clement Delmas, Francesco Campelo-Parada, Thibault Lhermusier, Frederic Bouisset, Meyer Elbaz, Vanessa Nader, Stephanie Blanco, Jerome Roncalli, Didier Carrie
Summary: Takotsubo cardiomyopathy is a clinical condition related to heart failure, with sympathetic nerve stimulation and catecholamine storm playing a role in its development. While the clinical course of the disease is generally mild, life-threatening complications can occur. Coronary angiography, left ventriculogram, transthoracic echocardiography and cardiac magnetic resonance imaging are key tools for diagnosis. Treatment usually involves conventional heart failure therapy, unless the patient is in critical condition or experiencing complications.
REVIEWS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Alexander R. Lyon, Rodolfo Citro, Birke Schneider, Olivier Morel, Jelena R. Ghadri, Christian Templin, Elmir Omerovic
Summary: Takotsubo syndrome, a recognized clinical entity for over three decades, poses challenges in understanding its pathophysiology and evidence-based treatments, requiring urgent need for specific and effective therapies.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2021)
Article
Cardiac & Cardiovascular Systems
Elmir Omerovic, Stefan James, David Erlinge, Henrik Hagstrom, Dimitrios Venetsanos, Loghman Henareh, Christina Ekenback, Joakim Alfredsson, Kristina Hambreus, Bjorn Redfors
Summary: BROKEN-SWEDEHEART is a multicenter randomized trial aiming to test the effectiveness of adenosine and dipyridamole in accelerating cardiac recovery and apixaban in reducing thromboembolic events in patients with TS. If successful, it will provide the first evidence-based treatment recommendation for TS.
AMERICAN HEART JOURNAL
(2023)
Review
Cardiac & Cardiovascular Systems
Avelyn Aw, Mechteld C. de Jong, Shriya Varghese, James Lee, Roger Foo, Rajeev Parameswaran
Summary: This review assessed the features and outcomes of pheochromocytoma-induced takotsubo cardiomyopathy (PCC-TCM), comparing typical and atypical subtypes. It found that atypical subtype patients were younger and had more severe clinical presentations and lower pre-operative mortality rates. However, the study also highlighted the need for further research to draw more reliable conclusions.
INTERNATIONAL JOURNAL OF CARDIOLOGY
(2023)
Review
Geriatrics & Gerontology
Monica Li, Christopher N. Nguyen, Olga Toleva, Puja K. Mehta
Summary: Takotsubo syndrome is an acute heart failure syndrome associated with increased cardiovascular morbidity and mortality. It predominantly affects women, especially post-menopausal women, but the reasons for this are unclear. Timely diagnosis through cardiac imaging is crucial for management of this condition. The syndrome can lead to life-threatening complications.
Review
Medicine, General & Internal
Francesco Santoro, Adriana Mallardi, Alessandra Leopizzi, Enrica Vitale, Elias Rawish, Thomas Stiermaier, Ingo Eitel, Natale D. Brunetti
Summary: Takotsubo syndrome, characterized by reversible left ventricular dysfunction, is managed using a combination of pharmacological and non-pharmacological approaches during the acute phase. Long-term management should be tailored based on individual cardiovascular and non-cardiovascular risk factors, as there is currently a lack of robust evidence for clinical effectiveness.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Ivan J. Nunez-Gil, Francesco Santoro, Ravi Vazirani, Giuseppina Novo, Emilia Blanco-Ponce, Luca Arcari, Aitor Uribarri, Luca Cacciotti, Federico Guerra, Jorge Salamanca, Beatrice Musumeci, Oscar Vedia, Enrica Mariano, Clara Fernandez-Cordon, Pasquale Caldarola, Roberta Montisci, Natale Daniele Brunetti, Ibrahim El-Battrawy, Mohammad Abumayyaleh, Ibrahim Akin, Ingo Eitel, Thomas Stiermaier
Summary: The study suggests that smoking may influence the clinical presentation and course of TTS with longer in-hospital stays, but does not independently impact mortality.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Review
Pharmacology & Pharmacy
Gao Jing Ong, Thanh Ha Nguyen, Sven Y. Surikow, John D. Horowitz
Summary: Takotsubo syndrome (TTS) is an acute inflammatory disorder that primarily affects the vasculature and myocardium. It is more prevalent in aging women, especially after acute physical and emotional stress, and can also be triggered by pharmacotherapy. This article discusses the pathogenesis of TTS, drug-induced cases, and available therapeutic information. The experts suggest interrupting the biochemical 'cascade' in TTS to improve symptoms and survival, and recommend long-term treatment with ACE inhibitors or angiotensin receptor antagonists. Results of ongoing clinical trials in this field are awaited.
EXPERT REVIEW OF CLINICAL PHARMACOLOGY
(2022)
Article
Medicine, General & Internal
Eric Landa, Erika Vigandt, Luis Moron, Manveer Ubhi, Basilides Fermin
Summary: Takotsubo cardiomyopathy, commonly seen in postmenopausal women, is a condition characterized by left ventricular dysfunction induced by emotional stress. It mimics acute coronary syndrome in presentation, leading to clean or nonobstructive coronary arteries in most patients after left heart catheterization.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Review
Biochemistry & Molecular Biology
Xuehui Fan, Guoqiang Yang, Jacqueline Kowitz, Ibrahim Akin, Xiaobo Zhou, Ibrahim El-Battrawy
Summary: Takotsubo syndrome (TTS) is an acute ventricular dysfunction characterized by reversible akinesia of the ventricular walls. The exact etiology is unclear, but it is believed to involve elevated levels of circulating plasma catecholamines, coronary microvascular dysfunction, and other factors. Current treatment options are limited, leading to the need for experimental models and platforms to study TTS. Excessive catecholamines can cause abnormal ventricular motion. This article reviews the pathophysiological mechanisms related to TTS and discusses the use of experimental models and platforms for TTS research.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2022)
Article
Medicine, General & Internal
Hamada Alsheikh, Nour Shaheen, Wageih Saber, Mostafa Meshref, Yara Amro, Ahmed Shaheen, Mahmoud Galal Ahmed, Sarya Swed
Summary: A patient with high-risk myocardial infarction was retroactively diagnosed with TCM after normal epicardial coronaries were revealed in coronary angiography. The patient underwent surgical repair of VSR and had a good recovery.
Review
Cardiac & Cardiovascular Systems
Takumi Osawa, Kazuko Tajiri, Masaki Ieda, Tomoko Ishizu
Summary: This study revealed significant associations between previous or active cancer and an increased risk of all-cause mortality and in-hospital adverse events in patients with TTS.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Review
Cardiac & Cardiovascular Systems
Lorraine Lok-Wing Chiang, Shek Long Tsang, Jing Xian Lee, Mengqi Gong, Tong Liu, Gary Tse, Dong Chang, Ishan Lakhani, Ka Hou Christien Li
Summary: Reduced LVEF, both as a categorical and continuous variable, is associated with increased mortality risk in Takotsubo cardiomyopathy patients. However, the presence of apical ballooning did not show a significant link with mortality risk.
HEART FAILURE REVIEWS
(2021)
