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https://hdl.handle.net/2440/130919
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Type: | Journal article |
Title: | Takotsubo syndrome: Finally emerging from the shadows? |
Author: | Ong, G.J. Nguyen, T.H. Kucia, A. Liu, S.-F. Surikow, S.Y. Girolamo, O. Chong, C.-R. Chirkov, Y.Y. Schenck-Gustafsson, K. Frenneaux, M.P. Horowitz, J.D. |
Citation: | Heart Lung and Circulation, 2021; 30(1):36-44 |
Publisher: | Elsevier BV |
Issue Date: | 2021 |
ISSN: | 1443-9506 1444-2892 |
Statement of Responsibility: | Gao Jing, Thanh Ha Nguyen, Angela Kucia, Sai-Fei Liu, Sven Y. Surikow, Olivia Girolamo, Cher-Rin Chong, Yuliy Y. Chirkov, Karin Schenck-Gustafsson, Michael P. Frenneaux, John D. Horowitz |
Abstract: | 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. |
Keywords: | Takotsubo syndrome β2-adrenoceptor signalling Nitrosative stress Cardiac magnetic resonance imaging |
Description: | Online published-ahead-of-print 6 November 2020 |
Rights: | © 2020 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). |
DOI: | 10.1016/j.hlc.2020.10.006 |
Published version: | http://dx.doi.org/10.1016/j.hlc.2020.10.006 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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