慢性阻塞性肺疾病急性加重期复发性应激性心肌病：仅归咎于β-肾上腺素能激动剂吗？

Recurrent Stress Cardiomyopathy During COPD Exacerbation: Are Beta-adrenergic Agonists Only to Blame?

作者信息

Katsa Ioanna, Christia Panagiota, Massera Daniele, Faillace Robert

机构信息

Medicine, North Bronx Health Network Jacobi Medical Center.

Cardiology, Montefiore Medical Center.

出版信息

Cureus. 2017 Apr 14;9(4):e1166. doi: 10.7759/cureus.1166.

DOI:10.7759/cureus.1166

PMID:28507838

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5429155/

Abstract

Takotsubo cardiomyopathy (TCM) is a variant of stress-induced cardiomyopathy, characterized by transient left ventricular dysfunction that may be associated with emotional or physical triggers. We present the case of a 51-year-old Caucasian female with severe chronic obstructive pulmonary disease (COPD) who presented with syncope and was found to have her second lifetime episode of stress-induced cardiomyopathy. Eight months prior, she had been admitted with a COPD exacerbation and was found to have left ventricular (LV) dysfunction with ejection fraction (EF) of 22% attributed to TCM with subsequent normalization of her left ventricular function. Recurrence of stress-induced cardiomyopathy associated with COPD is a rare phenomenon and its presentation raises the possibility of a common underlying mechanism.

摘要

应激性心肌病（Takotsubo心肌病，TCM）是应激性心肌病的一种变体，其特征为短暂性左心室功能障碍，可能与情绪或身体触发因素有关。我们报告一例51岁患有严重慢性阻塞性肺疾病（COPD）的白种女性病例，该患者出现晕厥，被发现发生了她一生中第二次应激性心肌病发作。八个月前，她因COPD急性加重入院，被发现存在左心室（LV）功能障碍，射血分数（EF）为22%，归因于TCM，随后左心室功能恢复正常。与COPD相关的应激性心肌病复发是一种罕见现象，其表现提示可能存在共同的潜在机制。