Guo Jiaming, Zhang Yiran, Jiang Xiaoyu, Wang Huinan, Guo Yaohan, Fan Yuxin, Peng Cai, Teng Catherine, Shi Ao, Lu Xiaojia, Ma Jianjun, Dong Man, Li Pengyang
Xinxiang Medical University, Xinxiang, Henan, China.
Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, USA.
Int J Cardiol Heart Vasc. 2025 Jan 27;56:101620. doi: 10.1016/j.ijcha.2025.101620. eCollection 2025 Feb.
Takotsubo syndrome (TTS) is identified by its acute and transient impairment of left ventricular systolic function. Although recent research has highlighted occurrences of TTS among individuals with gastrointestinal diseases (GI diseases), comprehensive and systematic investigations focusing on this patient demographic are still scarce.
This retrospective study analyzed case reports and series that documented an association between gastrointestinal diseases (GI diseases) and Takotsubo syndrome (TTS). We conducted comprehensive searches across PubMed, Embase, and the Cochrane Database to identify relevant cases.
In patients with gastrointestinal-induced Takotsubo syndrome (GI-TTS), the primary reasons for admission were pancreatitis (15.48 %), liver failure (10.71 %), bowel obstruction (5.95 %) and liver cirrhosis (5.95 %). It is noteworthy that the main triggers for Takotsubo syndrome are surgeries related to gastrointestinal diseases (29.76 %), including liver transplantation (15.48 %) and cholecystectomy (2.38 %). Dyspnea (45.71 %) was the most common symptom, followed by abdominal pain (35.71 %) and chest pain (34.29 %). The apical type was the most frequent TTS variant (81.25 %). Compared with the All-TTS cohort, GI-TTS patients were younger, and had a lower proportion of women (69.05 % vs. 89.77 %, P < 0.001). GI-TTS patients had higher ventilation use and lower usage of β-blockers, ACEI/ARBs, aspirin, and statins, while catecholamine use was more prevalent.
The study underscores the potential of gastrointestinal diseases and their treatments to trigger TTS, often presenting atypical clinical features compared to TTS of all types. Given these differences, an elevated level of clinical vigilance is imperative for the timely diagnosis of TTS in patients with gastrointestinal conditions.
应激性心肌病（TTS）以左心室收缩功能的急性和短暂损害为特征。尽管最近的研究强调了胃肠道疾病（GI疾病）患者中应激性心肌病的发生情况，但针对这一患者群体的全面系统研究仍然匮乏。
这项回顾性研究分析了记录胃肠道疾病（GI疾病）与应激性心肌病（TTS）之间关联的病例报告和系列研究。我们在PubMed、Embase和Cochrane数据库中进行了全面检索，以识别相关病例。
在胃肠道诱发的应激性心肌病（GI-TTS）患者中，入院的主要原因是胰腺炎（15.48%）、肝衰竭（10.71%）、肠梗阻（5.95%）和肝硬化（5.95%）。值得注意的是，应激性心肌病的主要诱发因素是与胃肠道疾病相关的手术（29.76%），包括肝移植（15.48%）和胆囊切除术（2.38%）。呼吸困难（45.71%）是最常见的症状，其次是腹痛（35.71%）和胸痛（34.29%）。心尖型是最常见的应激性心肌病类型（81.25%）。与所有应激性心肌病队列相比，GI-TTS患者更年轻，女性比例更低（69.05%对89.77%，P<0.001）。GI-TTS患者机械通气使用率更高，而β受体阻滞剂、ACEI/ARB、阿司匹林和他汀类药物的使用率更低，而儿茶酚胺的使用更为普遍。
该研究强调了胃肠道疾病及其治疗引发应激性心肌病的可能性，与所有类型的应激性心肌病相比，其临床表现往往不典型。鉴于这些差异，对于患有胃肠道疾病的患者，提高临床警惕水平对于及时诊断应激性心肌病至关重要。
