Emergency Department, San Antonio Hospital, Udine, Italy.
Ospedale Riabilitativo di Alta Specializzazione, Cardiologia Riabilitativa, Motta di Livenza, Italy.
Acta Cardiol. 2020 Jun;75(3):235-243. doi: 10.1080/00015385.2019.1572960. Epub 2019 Apr 6.
Takotsubo syndrome (TTS) is an acute heart syndrome characterised by reversible ventricular dysfunction with the absence of significant coronary occlusion, which typically occurs in postmenopausal women after emotional or physical stress. Differences of clinical or instrumental characteristics between fertile women and postmenopausal women with TTS have not yet been studied. The aim of this study was to investigate the differences in clinical, biochemical and echocardiographic characteristics between postmenopausal women and fertile women with TTS. One hundred and thirty-one patients (mean age 67.8 ± 11.3 years; 14 patients were still fertile) from four different Italian hospitals were enrolled, partially retrospectively and partial longitudinally. Physical examination, clinical history (including presenting symptoms and triggering stress factors), laboratory and ECG findings and Doppler echocardiography were collected at hospital admission. Echocardiography was repeated at discharge (after at least seven days from admission). No significant differences were observed considering trigger events or symptoms at presentation. Significant differences were observed considering left ventricle ejection fraction (LVEF) (37.9 ± 14.4% in fertile women, 43.9 ± 9.7% in postmenopausal women, = .033) and regional wall motion abnormalities. The apical ballooning pattern was predominant in postmenopausal women, instead the midventricular type was mainly observed in fertile women (36% 1% in fertile postmenopausal women respectively, < .001). Echocardiographic involvement of left ventricle is atypical in fertile women compared to women in menopause (midventricular apical ballooning, respectively). Moreover, the young group presented with worse LVEF but they had the same LV function at discharge and similar prognosis.
心尖球囊样综合征（TTS）是一种以心室功能可逆性障碍为特征的急性心脏综合征，无明显冠状动脉阻塞，通常发生在绝经后妇女经历情绪或身体应激后。绝经后妇女和 TTS 生育期妇女之间的临床或仪器特征差异尚未得到研究。本研究旨在探讨绝经后妇女和 TTS 生育期妇女之间临床、生化和超声心动图特征的差异。从意大利的四家不同医院招募了 131 名患者（平均年龄 67.8±11.3 岁；14 名患者仍处于生育期），部分为回顾性，部分为前瞻性。入院时收集体格检查、临床病史（包括首发症状和诱发应激因素）、实验室和心电图检查以及多普勒超声心动图。在出院时（入院后至少 7 天）重复进行超声心动图检查。在考虑触发事件或首发症状时，没有观察到显著差异。在左心室射血分数（LVEF）（生育期妇女为 37.9±14.4%，绝经后妇女为 43.9±9.7%，=0.033）和节段性壁运动异常方面观察到显著差异。绝经后妇女的顶端球囊样模式占优势，而生育期妇女主要观察到中隔型（分别为 36%和 1%，<0.001）。与绝经后妇女相比，生育期妇女的左心室超声心动图受累呈非典型性（分别为中隔型和顶端球囊样）。此外，年轻组的 LVEF 更差，但出院时左心室功能相同，预后相似。
