Lee Yian-Ping, Poh Kian-Keong, Lee Chi-Hang, Tan Huay-Cheem, Razak Abdul, Chia Boon-Lock, Low Adrian F
Int J Cardiol. 2009 Apr 3;133(2):272-5. doi: 10.1016/j.ijcard.2007.11.039. Epub 2008 Jan 10.
Stress-induced cardiomyopathy or Takotsubo cardiomyopathy is an uncommon disorder characterized by apical ballooning. The etiology and pathophysiology of this syndrome has not been fully evaluated. This case series examined the clinical characteristics and outcomes of 10 patients with confirmed stress-induced cardiomyopathy. We identified 10 cases of stress-induced cardiomyopathy. All exhibit characteristic apical ballooning and basal hyperkinesia except one with an "inverted Takotsubo" pattern. Coronary angiography excluded coronary artery stenoses as a cause of cardiomyopathy. Patient characteristics, cardiac function, follow-up echocardiography and outcomes were determined. 60% of cases were female and 70% of cases had ST-segment elevations. Identified precipitants included severe emotional stress, subarachnoid haemorrhage and sepsis. None of the cases had angiographically significant coronary stenosis. One patient had an "inverted Takotsubo" pattern with mid-ventricular ballooning. Stress-induced cardiomyopathy is a clinical spectrum which can present with a classical "Takotsubo" or "inverted Takotsubo" pattern. Presentation is varied but characterized by recovery to normal cardiac systolic function. Study of this syndrome may enhance further understanding of the "brain-heart" relationship.
应激性心肌病或Takotsubo心肌病是一种以心尖部气球样变特征的罕见疾病。该综合征的病因和病理生理学尚未得到充分评估。本病例系列研究了10例确诊为应激性心肌病患者的临床特征及预后。我们确定了10例应激性心肌病病例。除1例呈“倒转Takotsubo”模式外，所有病例均表现出特征性的心尖部气球样变和基底部运动增强。冠状动脉造影排除了冠状动脉狭窄作为心肌病病因的可能。确定了患者特征、心功能、随访超声心动图及预后情况。60%的病例为女性，70%的病例有ST段抬高。已确定的诱发因素包括严重情绪应激、蛛网膜下腔出血和脓毒症。所有病例均无血管造影显示的明显冠状动脉狭窄。1例患者呈“倒转Takotsubo”模式，表现为心室中部气球样变。应激性心肌病是一种临床谱，可表现为典型的“Takotsubo”或“倒转Takotsubo”模式。其表现多样，但特征为心脏收缩功能恢复正常。对该综合征的研究可能会增进对“脑-心”关系的进一步理解。
