Department of Cardiology, University Hospital of Rangueil, Toulouse, France.
Circ J. 2013;77(1):175-80. doi: 10.1253/circj.cj-12-0759. Epub 2012 Sep 13.
Recent retrospective studies suggest that psychiatric disorders could be a predisposing risk factor for Tako-tsubo cardiomyopathy (TTC). The aim of the present study was to characterize the prevalence of anxiodepressive disorders (ADD) and chronic psychological stress (CPS) in patients with TTC or acute coronary syndrome (ACS).
Between January 2010 and December 2011, 45 consecutive patients with TTC were prospectively screened by systematic interview with the Mini International Neuropsychiatric Interview. CPS was systematically recorded. During the same period, 50 patients admitted for ACS with troponin elevation and matched for age and sex were prospectively included as a control group. An acute stressful event within 72 h before presentation was identified in 35 patients (78%) with TTC vs. 9 (18%) with ACS (P<0.001). Thirty-five patients (78%) and 13 (26%) had ADD in the TTC and ACS groups, respectively (P<0.001). CPS was found in 20 patients (44%) and in 9 (18%) with TTC and ACS, respectively (P=0.005). CPS and/or ADD were found in 35 patients (78%) and in 18 (36%) with TTC and ACS, respectively (P<0.001).
ADD and CPS are common in patients with TTC and more frequent than in patients with ACS. This finding suggests that systemic effects of ADD and CPS could participate in the pathophysiology of TTC.
最近的回顾性研究表明，精神障碍可能是导致心尖球囊样综合征（TTC）的一个潜在危险因素。本研究的目的是描述 TTC 或急性冠状动脉综合征（ACS）患者中焦虑障碍（ADD）和慢性心理应激（CPS）的患病率。
2010 年 1 月至 2011 年 12 月期间，连续前瞻性筛选了 45 例 TTC 患者，通过系统访谈使用 Mini 国际神经精神访谈进行筛查。系统记录 CPS。同期纳入了 50 例因肌钙蛋白升高且年龄和性别相匹配而住院的 ACS 患者作为对照组。在 TTC 患者中，有 35 例（78%）在就诊前 72 小时内识别到急性应激事件，而在 ACS 患者中，有 9 例（18%）（P<0.001）。在 TTC 和 ACS 组中，分别有 35 例（78%）和 13 例（26%）患者患有 ADD（P<0.001）。在 TTC 组和 ACS 组中，分别有 20 例（44%）和 9 例（18%）患者发现 CPS（P=0.005）。在 TTC 和 ACS 组中，分别有 35 例（78%）和 18 例（36%）患者存在 CPS 和/或 ADD（P<0.001）。
ADD 和 CPS 在 TTC 患者中很常见，且比 ACS 患者更常见。这一发现提示，ADD 和 CPS 的全身性作用可能参与了 TTC 的病理生理过程。
