Kono Tatsuji, Sabbah Hani N
Department of Cardiovascular Medicine, Soseikai General Hospital, 101 Shimotoba, Hiroosa-machi, Fushimiku, Kyoto, 612-8473, Japan,
Heart Fail Rev. 2014 Sep;19(5):585-93. doi: 10.1007/s10741-013-9404-9.
Takotsubo cardiomyopathy (TC) is characterized by transient left ventricular apical wall motion abnormalities, chest pain with electrocardiographic changes, and modest myocardial enzymatic release mimicking acute coronary syndrome, but without significant coronary artery disease. TC is an increasingly recognized type of acquired cardiomyopathy occurring commonly after a recent stressful event, in particular emotional stress, and is relatively common in middle-aged and older women. The pathogenetic mechanism remains unknown. Catecholamine surge related to emotional distress seems to play a major role in the pathogenesis of this cardiomyopathy, rendering TC a type of neurocardiological disorder that manifests as acute but reversible heart failure. Clinicians should consider this syndrome in the differential diagnosis of patients presenting with clinical findings suggestive of acute coronary syndrome, especially in postmenopausal women with a recent history of acute emotional or physical stress.
应激性心肌病（TC）的特征为短暂性左心室心尖部壁运动异常、伴有心电图改变的胸痛以及类似于急性冠状动脉综合征的适度心肌酶释放，但无明显冠状动脉疾病。TC是一种越来越被认可的获得性心肌病类型，常见于近期发生应激事件后，尤其是情绪应激后，在中老年女性中相对常见。其发病机制尚不清楚。与情绪困扰相关的儿茶酚胺激增似乎在这种心肌病的发病机制中起主要作用，使TC成为一种表现为急性但可逆性心力衰竭的神经心脏疾病。临床医生在对表现出提示急性冠状动脉综合征临床症状的患者进行鉴别诊断时应考虑到这种综合征，尤其是近期有急性情绪或身体应激史的绝经后女性。
