Takotsubo 综合征患者的性激素全面评估。

Comprehensive assessment of sex hormones in Takotsubo syndrome.

机构信息

Department of Cardiology, Angiology and Intensive Care Medicine, Medical Clinic II, University Heart Center Lübeck, Lübeck, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Lübeck, Germany.

Department of Experimental and Clinical Endocrinology, Medical Clinic I, University Medical Center Lübeck, Lübeck, Germany.

出版信息

Int J Cardiol. 2018 Jan 1;250:11-15. doi: 10.1016/j.ijcard.2017.10.047.

DOI:10.1016/j.ijcard.2017.10.047

PMID:29169749

Abstract

BACKGROUND

The detailed pathomechanism of Takotsubo syndrome (TS) is still elusive. Due to the predominance of postmenopausal females, a potential role of sex hormones has been suggested. However, the limited available data are contradictory. The aim of this study was to comprehensively assess the role of sex hormone levels in a large cohort of TS patients.

METHODS

Serum samples of 57 female TS patients and 57 female patients with myocardial infarction (MI), matched for age (±2years) and repolarization disturbances were analyzed for estradiol (E2), estrone (E1), testosterone and androstenedione using liquid chromatography-tandem mass spectrometry.

RESULTS

There was no difference concerning the concentrations of E1 [pmol/l (IQR): 89.1 (62.5, 132.0) vs. 98.8 (63.3, 156.0), p=0,441], testosterone [nmol/l (IQR): 0.67 (0.46, 1.00) vs. 0.80 (0.49, 1.08), p=0.382] and androstenedione [nmol/l (IQR): 2.03 (1.57, 3.11) vs. 2.98 (1.48, 5.27), p=0.244] between female TS and MI patients. Regarding E2, the majority of patients demonstrated concentrations below the detection limit of 30pmol/l (TS: n=41/54, 75.9%; MI: n=32/53, 60.4%; p=0.078). The remaining individuals with detectable E2 concentrations did not show a significant difference between TS and MI patients [pmol/l (IQR): 40.5 (33.0, 53.3) vs. 54.1 (37.9, 60.9); p=0.20].

CONCLUSIONS

Altered sex hormone levels, especially an estradiol deficiency, could not be identified as a risk factor for TS.

摘要

背景

Takotsubo 综合征（TS）的详细发病机制仍不清楚。由于绝经后女性居多，因此有人提出性激素可能发挥作用。但是，目前有限的可用数据存在矛盾。本研究的目的是在一个大型 TS 患者队列中全面评估性激素水平的作用。

方法

使用液相色谱-串联质谱法分析 57 例女性 TS 患者和 57 例年龄（±2 岁）和复极障碍相匹配的心肌梗死（MI）女性患者的雌二醇（E2）、雌酮（E1）、睾丸酮和雄烯二酮血清样本。

结果

E1 浓度无差异[pmol/L（IQR）：89.1（62.5，132.0）与 98.8（63.3，156.0），p=0.441]、睾丸酮[nmol/L（IQR）：0.67（0.46，1.00）与 0.80（0.49，1.08），p=0.382]和雄烯二酮[nmol/L（IQR）：2.03（1.57，3.11）与 2.98（1.48，5.27），p=0.244]在女性 TS 和 MI 患者之间无差异。关于 E2，大多数患者的浓度低于 30pmol/L 的检测下限（TS：n=41/54，75.9%；MI：n=32/53，60.4%；p=0.078）。其余可检测到 E2 浓度的个体，TS 与 MI 患者之间无显著差异[pmol/L（IQR）：40.5（33.0，53.3）与 54.1（37.9，60.9）；p=0.20]。