TAKOTSUBO-LIKE CARDIOMYOPATHY IN A LARGE COHORT OF PATIENTS WITH PHEOCHROMOCYTOMA AND PARAGANGLIOMA
TAKOTSUBO-LIKE CARDIOMYOPATHY IN A LARGE COHORT OF PATIENTS WITH PHEOCHROMOCYTOMA AND PARAGANGLIOMA
复制标题
DOI：
10.4158/ep171930.or
复制
发表时间：
2017-10-01
影响因子：
4.2
通讯作者：
Bourdeau, Isabelle
中科院分区：
文献类型：
--
作者：
Gagnon, Nadia;Mansour, Samer;Bourdeau, Isabelle
目的：嗜铬细胞瘤（PHEO）和副神经节瘤（PGL）（PPGL）可引起急性Takotsubo样儿茶酚胺心肌病（TLC）。本研究的目的是确定一个大型PPGL.Methods患者队列中TLC的患病率和临床表现：我们回顾性分析了1995年至2016年在我们中心调查的连续PPGL患者的记录。我们收集了该队列中TLC患者的临床和临床旁数据。我们对1990年至2015年期间描述的与PPGL相关的Takotsubo心肌病病例进行了文献回顾。结果：我们的队列包括275例PPGL患者。在152例分泌型PPGL患者中发现4例（2.6%）急性TLC。123例术前分泌物不详（n = 51）或无PPGL分泌（n = 72）的患者未记录任何事件。4例患者（44 - 79岁）符合TLC标准，包括2例PHEO和2例PGL患者。在3例病例中确定了应激源事件，包括手术（n = 2）和上呼吸道感染。在所有病例中，PPGL的诊断都是在心脏事件发生后，以及在成像时偶然发现病变后进行的。此外，我们确定在文献中描述的59例在过去的25年中，并分析了这个队列与我们的4个新的cases.Conclusion：急性TLC可能被发现在高达3%的患者分泌PPGL。考虑到PPGL的诊断是在偶然发现放射学肿块后进行的，TTC中PPGL的真实的患病率仍有待确定。
Objective: Pheochromocytoma (PHEO) and paraganglioma (PGL) (PPGL) may cause acute Takotsubo-like catecholamine cardiomyopathy (TLC). The objective of this study was to determine the prevalence and clinical presentation of TLC in a large cohort of patients with PPGL.Methods: We reviewed retrospectively the records of consecutive patients with PPGL investigated in our center from 1995 to 2016. We collected clinical and paraclinical data of patients that had TLC in this cohort. We performed a literature review of cases of Takotsubo cardiomyopathy related to PPGL described between 1990 and 2015.Results: Our cohort included 275 patients with PPGL. Acute TLC was found in 4 of 152 (2.6%) patients with secreting PPGL. There was no event recorded in 123 patients with unknown presurgical secretion (n = 51) or nonsecreting PPGL (n = 72). Four patients (44 to 79 years old) fulfilled the criteria for TLC, including 2 PHEO and 2 PGL patients. A precipitating stressor event was identified in 3 cases including surgery (n = 2) and upper respiratory tract infection. In all cases, the diagnosis of PPGL came after the cardiac event and following the investigation of a lesion incidentally found at imaging. Moreover, we identified in the literature 59 cases described in the last 25 years and analyzed this cohort together with our 4 new cases.Conclusion: Acute TLC may be found in up to 3% of patients with secreting PPGL. Considering that the diagnosis of PPGL was performed following incidental finding of radiologic mass, the real prevalence of PPGL in TTC remains to be determined.