Vijiiac Aura, Ploscaru Vlad, Vatasescu Radu-Gabriel
Cardiology Department, Emergency Clinical Hospital Bucharest, Romania.
Maedica (Bucur). 2020 Mar;15(1):111-121. doi: 10.26574/maedica.2020.15.1.111.
Takotsubo syndrome has been traditionally considered a reversible form of acute heart failure triggered by an emotional or physical stressor, mainly occurring in women of post-menopausal age and often mimicking an acute coronary syndrome. While its pathophysiology is still incompletely understood, sympathetic overstimulation is known to play a central role in the disease. The classical hallmark of the condition was the presence of wall motion abnormalities limited to the apical segments of the ventricle, leading to the so-called apical ballooning, but different patterns of wall motion abnormalities are nowadays recognised. Different definitions and diagnostic criteria for takotsubo syndrome were proposed during the last decades, reflecting the heterogeneity of the condition and the gaps in the thorough understanding of the disease. While initially it was believed to be a benign entity, takotsubo syndrome has in fact similar morbidity and mortality with acute coronary syndromes, both on short- and long-term, highlighting the importance of proper risk stratification. Many questions still remain unanswered concerning the pathophysiology of the syndrome and the optimal therapeutic strategy for these patients.
应激性心肌病传统上被认为是一种由情绪或身体应激源引发的急性心力衰竭的可逆形式，主要发生在绝经后年龄的女性中，常表现类似急性冠状动脉综合征。虽然其病理生理学仍未完全明确，但已知交感神经过度刺激在该病中起核心作用。该病的典型特征是心室壁运动异常局限于心尖段，导致所谓的心尖气球样变，但如今已认识到不同的壁运动异常模式。在过去几十年里，人们提出了不同的应激性心肌病定义和诊断标准，这反映了该病的异质性以及对该疾病深入理解方面的差距。虽然最初人们认为它是一种良性疾病，但事实上，应激性心肌病在短期和长期内的发病率和死亡率与急性冠状动脉综合征相似，这凸显了进行适当风险分层的重要性。关于该综合征的病理生理学以及这些患者的最佳治疗策略，仍有许多问题未得到解答。
