Pathophysiology of Takotsubo Syndrome : Temporal Phases of Cardiovascular Responses to Extreme Stress

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  • Wright Peter T.
    National Heart and Lung Institute, Imperial College London
  • Tranter Matthew H.
    National Heart and Lung Institute, Imperial College London
  • Morley-Smith Andrew C.
    National Heart and Lung Institute, Imperial College London NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital
  • Lyon Alexander R.
    National Heart and Lung Institute, Imperial College London NIHR Cardiovascular Biomedical Research Unit, Royal Brompton Hospital

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タイトル別名
  • Pathophysiology of Takotsubo Syndrome
  • – Temporal Phases of Cardiovascular Responses to Extreme Stress –

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Takotsubo syndrome (TTS), also known as takotsubo cardiomyopathy, is an acute heart failure syndrome that typically occurs after a period of great emotional stress. The archetypal patient is a postmenopausal woman who presents with chest pain, ST-segment elevation and acute hypokinesia of the apical and middle segment of the left ventricle that extends beyond the territory of a single coronary artery, coupled with hyperkinesia of the basal myocardium. Recent preclinical and clinical studies have shown the importance of high catecholamine levels in precipitating TTS. We propose that this is caused by activation of β-adrenoceptors and the subsequent activation of a negatively-inotropic pathway, perhaps to protect the heart from catecholamine overload. We explore the pathophysiology of TTS according to its “phases”, both preclinically and clinically. This will show that the condition is not one of static apical hypokinesia that simply improves, but rather a dynamic condition that changes as the disease progresses. We hope that further exploration of TTS using its “phases” will aid in its characterization, diagnosis and treatment. (Circ J 2014; 78: 1550–1558)

収録刊行物

  • Circulation Journal

    Circulation Journal 78 (7), 1550-1558, 2014

    一般社団法人 日本循環器学会

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