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心肌顿抑综合征的最新研究进展。

An update on Takotsubo syndrome.

机构信息

St George's, University of London Medical School.

Pilgrim hospital, United Lincolnshire Hospitals NHS Trust.

出版信息

J Cardiovasc Med (Hagerstown). 2023 Oct 1;24(10):691-699. doi: 10.2459/JCM.0000000000001528. Epub 2023 Jul 18.

Abstract

Takotsubo syndrome (TTS) can be described as an acute, transiently occurring form of heart failure. It typically causes systolic dysfunction of the left ventricle (LV). Perhaps what is of most significance is the reversible nature of TTS, with many patients achieving recovery within a few weeks to months. TTS can be referred to by other names, attributed to its various precipitants, as well as the structural manifestations of the syndrome. Physical and emotional stressors have been identified as the most common of causes, hence the terms 'stress cardiomyopathy' and 'broken heart syndrome'. Precipitants can range from psychological, and hormonal, to molecular mechanisms. The symptoms of TTS can coalesce with other conditions and hence give rise to many differential diagnoses. Most patients present with dyspnoea and chest pain. The latter also presents in acute coronary syndrome (ACS); thus, ACS is a common differential diagnosis for TTS. The coronavirus disease 2019 (COVID-19) pandemic saw a drastic increase in mental health concerns which have persisted beyond this period. Further studies into personality disorders and their potential predisposition to COVID-19 and thus TTS would advance our understanding of the neuropsychiatric triggers of TTS. There is also a need for a single sensitive and specific diagnostic test for TTS as its diagnosis relies on the culmination of clinical presentation, echocardiography, cardiac catheterization, and cardiovascular magnetic resonance imaging (CMR).

摘要

心尖球囊综合征(TTS)可被描述为一种急性、短暂发生的心衰形式。它通常导致左心室(LV)收缩功能障碍。也许最重要的是 TTS 的可逆性,许多患者在数周到数月内恢复。TTS 可以根据其不同的诱因以及综合征的结构表现而有其他名称。身体和情绪应激源已被确定为最常见的原因,因此有“应激性心肌病”和“心碎综合征”的术语。诱因范围可以从心理、激素到分子机制。TTS 的症状可能与其他病症合并,因此产生许多鉴别诊断。大多数患者表现为呼吸困难和胸痛。后者也出现在急性冠状动脉综合征(ACS)中;因此,ACS 是 TTS 的常见鉴别诊断。2019 年冠状病毒病(COVID-19)大流行导致心理健康问题急剧增加,且这些问题在这一时期之后仍持续存在。进一步研究人格障碍及其对 COVID-19 和 TTS 的潜在易感性,将有助于我们理解 TTS 的神经精神触发因素。还需要一种单一的敏感和特异性 TTS 诊断测试,因为 TTS 的诊断依赖于临床表现、超声心动图、心导管检查和心血管磁共振成像(CMR)的综合结果。

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