Fazio Giovanni, Pizzuto Caterina, Barbaro Giuseppe, Sutera Loredana, Incalcaterra Egle, Evola Giovanna, Azzarelli Salvatore, Palecek Tomas, Di Gesaro Gabriele, Cascio Caterina, Novo Giuseppina, Akashi Yoshihiro J, Novo Salvatore
Int J Cardiol. 2008 Jun 23;127(1):121-3. doi: 10.1016/j.ijcard.2007.04.013. Epub 2007 Jun 1.
Takotsubo cardiomyopathy is a disorder that has been appreciated only recently. In most of reported cases, this syndrome mimes an acute myocardial infarction. Till this moment no data are available from literature about the treatment in the acute phase of this disease.
In our multicentric experience we have retrospectively looked at the benefits of a treatment with ACE-inhibitors, beta-blockers, Aspirin and calcium channels blockers, started until the early phases of the disease and continued for 30 days, in 36 patients affected by Takotsubo cardiomyopathy. We chose as endpoint of the study the efficacy of the used drug in improving left ventricular myocardial function and the rapidity of the effects of the same drug.bethods: from an international registry about the Takotsubo cardiomiopathy, co-ordinate by our research group, we evaluated the long term efficacy of some drugs, administrated like single treatment in some patients.
Obtained data did not show any statistically significant difference in the percentages of improvement in the left ventricle ejection fraction evaluated at the admission to the hospital, before the discharge and after 30 days of treatment between each treated group and the control group of non-treated patients. No significant differences were found in hospitalization times between treated patients and controls. None of our patients experienced during the observation period a relapse of the disease.
The results of our survey suggest that a chronic treatment with beta-blockers, ACE-inhibitors, calcium channels blockers and aspirin does not provide any benefit in patients with Takotsubo cardiomyopathy. Thus, it seem to be important an early correct differential diagnosis to avoid any chronic treatment in these patients.
应激性心肌病是一种直到最近才被认识的疾病。在大多数报道的病例中，这种综合征类似急性心肌梗死。到目前为止，文献中尚无关于该疾病急性期治疗的数据。
在我们的多中心经验中，我们回顾性地观察了36例应激性心肌病患者在疾病早期开始使用血管紧张素转换酶抑制剂、β受体阻滞剂、阿司匹林和钙通道阻滞剂治疗30天的益处。我们选择所用药物改善左心室心肌功能的疗效以及同一药物起效的速度作为研究终点。
从我们研究小组协调的关于应激性心肌病的国际登记处，我们评估了一些药物作为单一治疗在一些患者中的长期疗效。
所获得的数据显示，在入院时、出院前和治疗30天后评估的左心室射血分数改善百分比方面，各治疗组与未治疗的对照组之间没有任何统计学上的显著差异。治疗患者与对照组的住院时间没有显著差异。在观察期间，我们的患者均未出现疾病复发。
我们的调查结果表明，用β受体阻滞剂、血管紧张素转换酶抑制剂、钙通道阻滞剂和阿司匹林进行长期治疗对应激性心肌病患者没有任何益处。因此，早期正确的鉴别诊断对于避免对这些患者进行任何长期治疗似乎很重要。
