Takotsubo cardiomyopathy: a new form of acute, reversible heart failure.
Takotsubo cardiomyopathy: a new form of acute, reversible heart failure.
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DOI：
10.1161/circulationaha.108.767012
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发表时间：
2008-12-16
期刊：
影响因子：
37.8
通讯作者：
Ueyama T
中科院分区：
文献类型：
--
作者：
Akashi YJ;Goldstein DS;Barbaro G;Ueyama T
最近的几个病例报告和系列报道描述了一种以急性心肌梗塞的症状和体征为特征的疾病，但没有明显的冠状动脉狭窄或痉挛，其中心脏呈现出日本章鱼捕捞罐（称为“takotsubo”）的外观（图 1）。在章鱼壶心肌病（也称为短暂性心尖气球样变和应激性心肌病）中，左心室功能障碍可能会显着降低，但会在几周内恢复。 1-4 Takotsubo 心肌病主要发生在绝经后妇女在遭受突然的、意外的情绪或身体压力后不久。例如，居住在新泻地震震中附近的老年妇女中章鱼壶心肌病的发病率大幅增加。 4 虽然左心室功能障碍是暂时的，并且没有阻塞性心外膜冠状动脉疾病的证据，但针对推测的急性冠状动脉综合征进行的血管成形术越来越多。关于这种可逆性左心室衰竭的人口统计学、临床特征、预后和治疗的概念仍在不断发展。在这篇简短的综述中，我们总结了最近的临床报告，并讨论了可能阐明这种疾病发病机制的动物模型。
Several relatively recent case reports and series have described a condition featuring symptoms and signs of acute myocardial infarction without demonstrable coronary artery stenosis or spasm in which the heart takes on the appearance of a Japanese octopus fishing pot called a takotsubo (Figure 1). In takotsubo cardiomyopathy (also called transient apical ballooning and stress cardiomyopathy), left ventricular dysfunction, which can be remarkably depressed, recovers within a few weeks. 1–4 Takotsubo cardiomyopathy occurs predominantly in postmenopausal women soon after exposure to sudden, unexpected emotional or physical stress. For instance, the incidence of takotsubo cardiomyopathy increased substantially in elderly women living near the epicenter of the Niigata earthquake. 4 Although the left ventricular dysfunction is transient and there is no evidence of obstructive epicardial coronary disease, an increasing number of angioplasty procedures have been performed for presumed acute coronary syndromes. Concepts about the demographics, clinical features, prognosis, and management of this reversible form of left ventricular failure are still evolving. In this brief review, we summarize recent clinical reports and discuss an animal model that may clarify the pathogenesis of this condition.