Pang Si, Huang Haobo, Zhu Yunlong, Zhou Rong, Tan Dan, Zhang Yuqing, Wu Mingxing
Department of Cardiology, Xiangtan Central Hospital (The Affiliated Hospital of Hunan University), Xiangtan, China.
Front Cardiovasc Med. 2025 Mar 11;12:1516080. doi: 10.3389/fcvm.2025.1516080. eCollection 2025.
Takotsubo syndrome (TTS), characterized by transient wall motion aberrations and clinical manifestations akin to acute coronary syndrome, predominantly arises from significant physical or emotional stress, often throughout the perioperative period. The prevalence and mechanisms of this condition remain inadequately elucidated, particularly in the context of transcatheter valvular disease procedures. This knowledge gap may result in under-recognition and subsequent delays in diagnosis.
A 76-year-old female was scheduled in our department for mitral transcatheter edge-to-edge repair (TEER). Despite the procedural success, multi-lead T-wave inversions and a 43% decrease in ejection fraction accompanied by new apical hypokinesis were noted postoperatively. Subsequent assessment revealed TTS. After receiving the optimal medical therapy, the patient was discharged after 10 days without experiencing acute chest pain or shortness of breath. The patient's electrocardiogram (ECG) and function of the left ventricular function, particularly regional wall motion abnormalities, recovered on the 20th day after surgery.
The limited literature reporting TTS post-TEER that we reviewed suggests that this rare complication must be anticipated in patients exhibiting an unexpected postoperative ECG and impaired myocardial contraction.
Researchers call for high-risk patient identification, adequate preoperative evaluation, and vigilant postoperative monitoring, and note the significance of early detection in optimizing therapeutic outcomes. Further research is imperative to further explore the management and prognosis of TTS following TEER.
应激性心肌病（TTS）以短暂的室壁运动异常及类似于急性冠脉综合征的临床表现为特征，主要由重大的身体或情绪应激引发，常在围手术期发生。这种疾病的患病率及发病机制仍未得到充分阐明，尤其是在经导管瓣膜病手术的背景下。这一知识空白可能导致认识不足及随后的诊断延误。
一名76岁女性在我院计划进行二尖瓣经导管缘对缘修复术（TEER）。尽管手术成功，但术后出现多导联T波倒置，射血分数下降43%，并伴有新出现的心尖运动减弱。后续评估显示为应激性心肌病。在接受最佳药物治疗后，患者于10天后出院，未出现急性胸痛或气短症状。患者的心电图（ECG）及左心室功能，尤其是局部室壁运动异常，在术后第20天恢复。
我们查阅的关于TEER术后应激性心肌病的有限文献表明，对于术后出现意外心电图及心肌收缩功能受损的患者，必须预见到这种罕见并发症。
研究人员呼吁识别高危患者、进行充分的术前评估及术后密切监测，并指出早期检测对于优化治疗结果的重要性。有必要进一步研究以进一步探索TEER术后应激性心肌病的管理及预后。
