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章鱼壶中的“被困之心”:应激性心肌病;实体器官移植后罕见临床综合征综述

A "Trapped Heart" in an Octopus Pot: Takotsubo Cardiomyopathy; Review of a Rare Clinical Syndrome Following Solid-Organ Transplant.

作者信息

Vailas Michail G, Moris Demetrios, Papalampros Alexandros, Sotiropoulou Maria, Schizas Demetrios, Davakis Spiridon, Vernadakis Spiridon

机构信息

First Department of Surgery, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

出版信息

Exp Clin Transplant. 2017 Oct;15(5):490-496.

Abstract

OBJECTIVES

Takotsubo cardiomyopathy, also known as "broken heart syndrome," "apical ballooning syndrome," and "stress-induced cardiomyopathy," was first des cribed in Japanese patients in 1990 by Sato and colleagues. Takotsubo cardiomyopathy is an increasingly recognized syndrome characterized by transient and reversible systolic dysfunction of the apical and middle segments of the left ventricle. This syndrome resembles acute myocardial infarction in the absence of evident coronary artery occlusion. Although the precise pathophysiology of takotsubo cardiomyopathy is still unknown, it seems that it is associated with excessive sympathetic stimulation, microvascular dysfunction, coronary artery vasospasm, and abnormal myocardial tissue metabolism.

MATERIALS AND METHODS

Herein, we sought to recognize and summarize the available literature data on Takotsubo cardiomyopathy regarding solid-organ transplant, in an attempt to provide the demographic and morphologic functional characteristics of patients with Takotsubo cardiomyopathy and related clinical implications.

RESULTS AND CONCLUSIONS

Transplant surgeons should maintain a high index of clinical suspicion and never underestimate takotsubo cardiomyopathy as a potential cause of heart failure following solid-organ transplant.

摘要

目的

应激性心肌病,也被称为“心碎综合征”“心尖球囊样综合征”和“应激性心肌病”,1990年由佐藤及其同事首次在日本患者中描述。应激性心肌病是一种越来越被认可的综合征,其特征是左心室心尖段和中间段出现短暂且可逆的收缩功能障碍。该综合征在无明显冠状动脉闭塞的情况下类似于急性心肌梗死。尽管应激性心肌病的确切病理生理学仍不清楚,但似乎与过度交感神经刺激、微血管功能障碍、冠状动脉痉挛及心肌组织代谢异常有关。

材料与方法

在此,我们试图识别并总结关于实体器官移植的应激性心肌病的现有文献数据,以提供应激性心肌病患者的人口统计学和形态功能特征及相关临床意义。

结果与结论

移植外科医生应保持高度的临床怀疑指数,绝不能低估应激性心肌病作为实体器官移植后心力衰竭潜在原因的可能性。

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