Reversible left ventricular dysfunction "takotsubo" cardiomyopathy related to catecholamine cardiotoxicity
Reversible left ventricular dysfunction "takotsubo" cardiomyopathy related to catecholamine cardiotoxicity
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DOI：
10.1054/jelc.2002.36277
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发表时间：
2002-10-01
影响因子：
1.3
通讯作者：
Sasaka, K
中科院分区：
文献类型：
--
作者：
Akashi, YJ;Nakazawa, K;Sasaka, K
一名80岁女性因持续性意识障碍入院。心电图显示11、111、aVf和V3-V6导联ST段抬高。冠状动脉造影显示正常动脉，而左心室造影显示心尖运动不能和基底运动过度的不协调。在入院时进行初始测量后，肌酐激酶和肌酐激酶MB水平未升高。弥漫性ST段抬高在入院后24小时达到最高水平。V3 ~ V6导联ST段持续抬高48 h，随访T波深倒置。在24天内，不经任何特殊治疗，运动失调得到改善，但心电图上出现巨大的负T波。入院第一天血浆去甲肾上腺素和脑钠肽水平分别为2.9ng/mL和906 pg/mL。高水平血浆儿茶酚胺暴露可引起左心室功能障碍。I-123-间碘苄胍造影也显示心脏儿茶酚胺动力学的短暂功能障碍。
An 80-year-old female was admitted for a persistent consciousness disturbance. Electrocardiography revealed ST-segment elevation in leads 11, 111, aVf, and V3-V6. Coronary angiography demonstrated normal arteries, while left ventriculography revealed asynergy of apical akinesis and basal hyperkinesis. The creatinine kinase and creatinine kinase MB levels were not elevated after the initial measurement on admission. The diffuse ST-segment elevation reached a maximum level 24 hours after admission. in leads V3-V6, ST-segment elevation continued for 48 hours, and was followed-up by deep inverted T waves. Within 24 days, the asynergy improved without any specific treatment, but the giant negative T waves were present on the electrocardiogram. The plasma norepinephrine and brain natriuretic peptide levels on the first hospital day were 2.9ng/mL and 906pg/mL, respectively. The left ventricular dysfunction appeared to be induced by the exposure to high-level plasma catecholamines. I-123-metaiodobenzyl guanidine scintigraphy also revealed transient dysfunction of the cardiac catecholamine dynamics.