Stöllberger Claudia, Finsterer Josef, Schneider Birke
Medical Department, Krankenanstalt Rudolfstiftung, Vienna, Austria.
Can J Cardiol. 2006 Oct;22(12):1063-8. doi: 10.1016/s0828-282x(06)70322-1.
Tako-tsubo-like left ventricular dysfunction phenomenon (TTP) is characterized by transient left ventricular apical ballooning associated with symptoms, electrocardiographic changes and minimal cardiac enzyme release in the absence of coronary artery disease. Initially described in Japan, TTP occurs worldwide, predominantly in women and frequently after emotional or physical stress. Symptoms include anginal chest pain, dyspnea and syncope. Electrocardiographic ST elevations may be present only for several hours, and are followed by negative T waves that persist for months. Arterial hypertension is found in up to 76% of TTP patients, hyperlipidemia in up to 57% and diabetes mellitus in up to 12%. Potential pathophysiological mechanisms for TTP include catecholamine-induced myocardial stunning or hyperkinesis of the basal left ventricular segments, coronary vasospasm, plaque rupture, myocarditis and genetic factors. TTP patients should be monitored similarly to myocardial infarction patients because organ failure, cardiogenic shock, ventricular fibrillation or rupture may occur. Beta-blockers are indicated, whereas catecholamines and nitrates should be avoided. The long-term prognosis is unknown.
类Takotsubo型左心室功能障碍现象（TTP）的特征是左心室心尖部短暂性气球样扩张，伴有症状、心电图改变，且在无冠状动脉疾病的情况下心肌酶释放极少。TTP最初在日本被描述，在全球范围内均有发生，主要见于女性，且常发生于情绪或身体应激之后。症状包括心绞痛、呼吸困难和晕厥。心电图ST段抬高可能仅持续数小时，随后出现持续数月的倒置T波。高达76%的TTP患者存在动脉高血压，高达57%的患者存在高脂血症，高达12%的患者存在糖尿病。TTP潜在的病理生理机制包括儿茶酚胺诱导的心肌顿抑或左心室基底节段运动亢进、冠状动脉痉挛、斑块破裂、心肌炎和遗传因素。TTP患者应与心肌梗死患者接受类似的监测，因为可能会发生器官衰竭、心源性休克、心室颤动或破裂。应使用β受体阻滞剂，而应避免使用儿茶酚胺和硝酸盐。其长期预后尚不清楚。
