Lazzeroni Davide, Bini Matteo, Castiglioni Paolo, Moderato Luca, Ciracì Chiara, Camaiora Umberto, Ugolotti Pietro Tito, Brambilla Lorenzo, Brambilla Valerio, Garibaldi Silvia, Paglialonga Letizia, Ziveri Valentina, Ugo Fabrizio, Gaibazzi Nicola, Coruzzi Paolo
Department of Clinical and Experimental Medicine, University of Parma, Italy.
Cardiol J. 2018;25(4):495-500. doi: 10.5603/CJ.a2017.0136. Epub 2017 Nov 23.
Anxiety disorders are more common in Takotsubo syndrome (TS) than in acute coronary syndrome patients. The aim of this study was to investigate whether pre-existing anxiety disorders predispose to TS triggered by exclusively emotional stressful events.
Triggering events were compared in 58 TS patients with and without pre-existing anxiety disorders; clinical, electrocardiographic and echocardiographic data were also collected.
Thirty-one (53%) patients had a previous history of anxiety disorders. The exclusively emotional stressful event-rate was higher in TS patients with pre-existing anxiety disorder (74% vs. 30%, p = 0.001), while TS caused by an undetermined trigger were significantly higher in patients without anxiety disorders (33% vs. 10%, p = 0.027). Moreover, in TS patients without a previous history of anxiety disorders, a trend of higher prevalence of physical events was found (16% vs. 37%, p = 0.07).
In patients with pre-existing anxiety disorders, TS was predominantly triggered by exclusively emotional stressful events, thereby suggesting a possible relationship between anxiety and emotional cardiac frailty in TS patients.
与急性冠状动脉综合征患者相比，焦虑症在应激性心肌病（TS）中更为常见。本研究旨在调查既往存在的焦虑症是否易导致仅由情绪应激事件引发的TS。
比较了58例有或无既往焦虑症的TS患者的触发事件；还收集了临床、心电图和超声心动图数据。
31例（53%）患者有焦虑症病史。既往有焦虑症的TS患者中仅由情绪应激事件引发的比例更高（74%对30%，p = 0.001），而无焦虑症患者中由不明触发因素导致的TS比例显著更高（33%对10%，p = 0.027）。此外，在无焦虑症病史的TS患者中，发现身体事件的患病率有升高趋势（16%对37%，p = 0.07）。
在既往有焦虑症的患者中，TS主要由仅情绪应激事件引发，从而提示TS患者焦虑与情绪性心脏脆弱之间可能存在关联。
