Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Policlinico Universitario, Via Giustiniani, 2, 35128 Padova, Italy.
Eur J Heart Fail. 2010 Mar;12(3):305-8. doi: 10.1093/eurjhf/hfp205. Epub 2010 Jan 22.
Takotsubo syndrome, also called apical ballooning syndrome, is a clinical entity characterized by transient hypokinesis, akinesis, or dyskinesis of the left ventricular mid-segments with or without apical involvement, and without obstructive coronary lesions. The contemporary presence of left ventricular outflow tract obstruction (LVOTO), systolic anterior motion of the anterior mitral leaflet, and acute mitral regurgitation might explain the worsening of the heart failure or the occurrence of cardiogenic shock in some patients with apical ballooning syndrome. The use of beta-blockers should improve the LVOTO gradient by reducing basal hypercontractility, increasing left ventricular filling and size, and reducing heart rate. However, clear evidence of the direct haemodynamic effects of beta-blockers is still lacking. We present a case of apical ballooning syndrome complicated by dynamic LVOTO, treated with metoprolol.
心尖球囊综合征，也称为心尖球形综合征，是一种临床病症，其特征为短暂性左心室中部运动减弱、无运动或运动障碍，伴有或不伴有心尖部受累，且无阻塞性冠状动脉病变。左心室流出道梗阻（LVOTO）、前二尖瓣叶收缩期前向运动和急性二尖瓣反流的同时存在，可能解释了一些心尖球囊综合征患者心力衰竭恶化或心源性休克的发生。β受体阻滞剂的使用可以通过降低基础高收缩性、增加左心室充盈和大小以及降低心率来改善 LVOTO 梯度。然而，β受体阻滞剂对血流动力学的直接影响仍缺乏明确的证据。我们报告了一例心尖球囊综合征并发动态 LVOTO 的病例，该患者使用美托洛尔治疗。
