Reil Jan-Christian, Sequeira Vasco, Reil Gert-Hinrich, Steendijk Paul, Maack Christoph, Fink Thomas, Rawish Elias, Eitel Ingo, Stiermaier Thomas
Klinik für allgemeine und interventionelle Kardiolgie, Herz-und Diabetes-Zentrum Nordrhein-Westphalen, Georgstrasse 11, 32545, Bad Oeynhausen, Germany.
DZHI, Department of Translational Science Universitätsklinikum, Würzburg, Germany.
Commun Med (Lond). 2024 Nov 1;4(1):223. doi: 10.1038/s43856-024-00641-5.
Takotsubo syndrome is characterized by transient regional systolic dysfunction, left ventricular (LV) dilatation, and edema, often occurring without obstructive coronary artery disease. The mechanisms underlying this stress-induced condition, especially the role of mechanical dyssynchrony in affecting systolic function, remain poorly understood.
In our study, we evaluated global LV function and mechanical dyssynchrony in 24 Takotsubo patients compared to 20 controls by analyzing pressure-volume loops and time-varying elastance. Additionally, we monitored changes in LV segmental volume and internal flow.
Here we show a significant reduction in global myocardial contractility and pronounced mechanical dyssynchrony in Takotsubo syndrome, particularly in the mid and apical LV segments, without disturbances in electrical conduction.
Our findings reveal substantial mechanical dyssynchrony in Takotsubo patients, characterized by increased internal flow and a shortened systolic ejection time. This indicates a mechanical basis for the inefficient LV function in Takotsubo syndrome, independent of electrical conduction abnormalities.
应激性心肌病的特征为短暂的局部收缩功能障碍、左心室（LV）扩张和水肿，常发生于无阻塞性冠状动脉疾病的情况下。这种应激诱导状态的潜在机制，尤其是机械不同步在影响收缩功能中的作用，仍知之甚少。
在我们的研究中，我们通过分析压力-容积环和时变弹性，评估了24例应激性心肌病患者与20例对照者的左心室整体功能和机械不同步。此外，我们监测了左心室节段容积和内部血流的变化。
我们发现应激性心肌病患者的整体心肌收缩力显著降低，且存在明显的机械不同步，尤其是在左心室中部和心尖节段，而电传导无异常。
我们的研究结果揭示了应激性心肌病患者存在明显的机械不同步，其特征为内部血流增加和收缩期射血时间缩短。这表明应激性心肌病患者左心室功能低效存在机械基础，与电传导异常无关。
