Department of Hypertension, Medical University of Lodz, Poland.
Int J Cardiol. 2010 Jul 9;142(2):120-5. doi: 10.1016/j.ijcard.2009.11.040. Epub 2010 Jan 3.
Takotsubo cardiomyopathy is defined as acute chest pain during stressful incidents which is associated with ST-segment abnormalities and/or increased serum troponin levels. There is also regressive systolic dysfunction which is usually localized in the apical and medial left ventricles but there are no significant coronary artery lesions. The ventricular asynergy is also described in the right ventricle but is less common. Almost all the patients are women. The onset of this disease is typically triggered by an acute emotional or stress event or by an accumulation of trivial and repetitive stresses. The etiology of this syndrome remains unclear. Myocardial ischemia and reperfusion due to microvascular spasm, aborted myocardial infarction and related no-reflow phenomenon have been proposed as inducers of Takotsubo cardiomyopathy. The temporal relationship between the stressful event and the triggering of the clinical syndrome as well as the report of elevated catecholamine plasma levels during the acute phase suggest a possible involvement of the sympathetic nervous system. A smaller left ventricular size and hormonal disturbances in women may also play a role.
应激性心肌病定义为在应激事件期间发生的急性胸痛，其与 ST 段异常和/或血清肌钙蛋白水平升高相关。还存在退行性收缩功能障碍，通常局限于心尖和内侧左心室，但不存在明显的冠状动脉病变。右心室也存在心室不同步，但较少见。几乎所有患者均为女性。该疾病的发病通常由急性情绪或应激事件或由琐碎和重复的应激积累触发。该综合征的病因仍不清楚。由于微血管痉挛、心肌梗死未遂和相关的无复流现象，提出心肌缺血再灌注可能是应激性心肌病的诱因。应激事件与临床综合征触发之间的时间关系以及在急性期报告的儿茶酚胺血浆水平升高提示交感神经系统可能参与其中。较小的左心室大小和女性的激素紊乱也可能起作用。
