Gupta Sanjiv, Gupta Madan Mohan
NH Narayana Multispeciality Hospital, Jaipur, India.
Heart and Diabetic Clinic, B-19, Rajender Marg, Bapu Nagar, Jaipur, India.
Indian Heart J. 2018 Jan-Feb;70(1):165-174. doi: 10.1016/j.ihj.2017.09.005. Epub 2017 Sep 13.
Takotsubo syndrome is a reversible acute heart failure frequently precipitated by an emotional or physical stress. The clinical presentation resembles acute coronary syndrome. Pathogenesis is complex and may involve brain-heart axis and neuro-hormonal stunning of the myocardium. Coronary angiography reveals normal epicardial arteries with no obstruction or spasm. NT-ProBNP maybe remarkably elevated. Regional wall motion akinesia (RWMA) of left ventricle extends beyond the territory of one coronary artery. Reduced left ventricle ejection fraction (LVEF) and RWMA recover in 6-12 weeks. Prognosis is generally good. Recent meta-analysis shows in-hospital mortality of 1-4.5% and recurrence rate of 5-10% during five year follow-up.
应激性心肌病是一种常由情绪或身体应激诱发的可逆性急性心力衰竭。其临床表现类似于急性冠状动脉综合征。发病机制复杂，可能涉及脑-心轴以及心肌的神经激素性晕厥。冠状动脉造影显示心外膜动脉正常，无阻塞或痉挛。N末端B型利钠肽原（NT-ProBNP）可能显著升高。左心室节段性室壁运动减弱（RWMA）超出一支冠状动脉供血区域。左心室射血分数（LVEF）降低及RWMA在6至12周内恢复。总体预后良好。近期的荟萃分析显示，住院死亡率为1%至4.5%，五年随访期间复发率为5%至10%。
