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https://www.readbyqxmd.com/read/28439851/exploring-the-pathophysiology-of-takotsubo-cardiomyopathy
#1
REVIEW
Wengen Chen, Vasken Dilsizian
PURPOSE OF REVIEW: The purpose of this review is to explore the pathophysiology of Takotsubo cardiomyopathy by appraising the interplay between myocardial perfusion, function, metabolism, and, particularly, sympathetic innervation. RECENT FINDINGS: A number of hypotheses have been proposed to explain the pathogenesis of Takotsubo cardiomyopathy, which include (1) catecholamine cardiac toxicity, (2) myocardial sympathetic innervation disruption, (3) coronary vasospasm, (4) myocardial microvascular dysfunction, and (5) aborted myocardial infarction...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28416795/neutrophil-stunning-by-metoprolol-reduces-infarct-size
#2
Jaime García-Prieto, Rocío Villena-Gutiérrez, Mónica Gómez, Esther Bernardo, Andrés Pun-García, Inés García-Lunar, Georgiana Crainiciuc, Rodrigo Fernández-Jiménez, Vinatha Sreeramkumar, Rafael Bourio-Martínez, José M García-Ruiz, Alfonso Serrano Del Valle, David Sanz-Rosa, Gonzalo Pizarro, Antonio Fernández-Ortiz, Andrés Hidalgo, Valentín Fuster, Borja Ibanez
The β1-adrenergic-receptor (ADRB1) antagonist metoprolol reduces infarct size in acute myocardial infarction (AMI) patients. The prevailing view has been that metoprolol acts mainly on cardiomyocytes. Here, we demonstrate that metoprolol reduces reperfusion injury by targeting the haematopoietic compartment. Metoprolol inhibits neutrophil migration in an ADRB1-dependent manner. Metoprolol acts during early phases of neutrophil recruitment by impairing structural and functional rearrangements needed for productive engagement of circulating platelets, resulting in erratic intravascular dynamics and blunted inflammation...
April 18, 2017: Nature Communications
https://www.readbyqxmd.com/read/28409033/aborted-sudden-cardiac-death-in-a-female-patient-presenting-with-takotsubo-like-cardiomyopathy-due-to-epicardial-coronary-vasospasm
#3
Sorin Giusca, Tom Eisele, Peter Nunninger, Benedikt Münz, Grigorios Korosoglou
Takotsubo cardiomyopathy is characterized by apical ballooning of the left ventricle (LV) in the absence of relevant coronary artery stenosis, which typically occurs in elderly women after emotional stress. Catecholamine cardiotoxicity, metabolic disturbance, and coronary microvascular impairment have previously been proposed as underlying pathophysiologic mechanisms of takotsubo cardiomyopathy, whereas myocardial stunning resulting from epicardial coronary artery vasospasm is not generally accepted as a cause of takotsubo cardiomyopathy...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#4
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28286377/ischemia-reperfusion-injury-following-acute-myocardial-infarction-a-critical-issue-for-clinicians-and-forensic-pathologists
#5
REVIEW
Margherita Neri, Irene Riezzo, Natascha Pascale, Cristoforo Pomara, Emanuela Turillazzi
Acute myocardial infarction (AMI) is a leading cause of morbidity and mortality. Reperfusion strategies are the current standard therapy for AMI. However, they may result in paradoxical cardiomyocyte dysfunction, known as ischemic reperfusion injury (IRI). Different forms of IRI are recognized, of which only the first two are reversible: reperfusion-induced arrhythmias, myocardial stunning, microvascular obstruction, and lethal myocardial reperfusion injury. Sudden death is the most common pattern for ischemia-induced lethal ventricular arrhythmias during AMI...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28216496/-clinical-value-of-the-evolution-of-left-ventricular-global-strain-in-anterior-myocardial-infarction-patients-treated-with-emergency-percutaneous-coronary-intervention
#6
Zurong Yang, Qichang Zhou, Zhenfei Fang, Danming Cao, Jiawei Zhou, Xiankui Tan
To investigate the evolution of left ventricular global strain in anterior myocardial infarction patients treated with emergency percutaneous coronary intervention (PCI).
 Methods: A total of 54 patients with PCI were enrolled as a PCI group. Forty healthy subjects were enrolled as a control group. Dynamic cardiac images were collected. All of these images were analyzed off-line by velocity vector imaging (VVI) software. N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured with an electrochemiluminescence immunoassay through the Elecsys 1010/2010 system...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28187814/neurocardiology
#7
REVIEW
N D Osteraas, V H Lee
Neurocardiology refers to the interplay between the nervous system and the cardiovascular system. Stress-related cardiomyopathy exemplifies the brain-heart connection and occurs in several conditions with acute brain injury that share oversympathetic activation. The brain's influences on the heart can include elevated cardiac markers, arrhythmias, repolarization abnormalities on electrocardiogram, myocardial necrosis, and autonomic dysfunction. The neurogenic stunned myocardium in aneurysmal subarachnoid hemorrhage represents one end of the spectrum, and is associated with an explosive rise in intracranial pressure that results in excess catecholamine state and possibly CBN...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28122851/intradialytic-cardiac-magnetic-resonance-imaging-to-assess-cardiovascular-responses-in-a-short-term-trial-of-hemodiafiltration-and-hemodialysis
#8
Charlotte Buchanan, Azharuddin Mohammed, Eleanor Cox, Katrin Köhler, Bernard Canaud, Maarten W Taal, Nicholas M Selby, Susan Francis, Chris W McIntyre
Hemodynamic stress during hemodialysis (HD) results in recurrent segmental ischemic injury (myocardial stunning) that drives cumulative cardiac damage. We performed a fully comprehensive study of the cardiovascular effect of dialysis sessions using intradialytic cardiac magnetic resonance imaging (MRI) to examine the comparative acute effects of standard HD versus hemodiafiltration (HDF) in stable patients. We randomly allocated 12 patients on HD (ages 32-72 years old) to either HD or HDF. Patients were stabilized on a modality for 2 weeks before undergoing serial cardiac MRI assessment during dialysis...
April 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28095748/myocardial-inactivation-of-thyroid-hormones-in-patients-with-aortic-stenosis
#9
Bruno S Paolino, Pablo M Pomerantzeff, Luís Alberto O Dallan, Fabio A Gaiotto, Nailliw Z Preite, Ana Claudia Latrônico, José Carlos Nicolau, Antonio C Bianco, Roberto R C V Giraldez
OBJECTIVE: The human heart expresses the type 2 deiodinase (D2) that activates thyroxine (T4) to triiodothyronine (T3). At the same time, the inactivating type 3 deiodinase (D3) has been found in a rat model of right ventricular hypertrophy. It is not known whether the human myocardium metabolizes thyroid hormone. This study examined myocardial thyroid hormone metabolism in patients with aortic valve stenosis (AS) undergoing aortic valve replacement and in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting surgery...
April 12, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28054182/takotsubo-cardiomyopathy-fdg-myocardial-uptake-pattern-in-fasting-patients-comparison-of-pet-ct-spect-and-echo-results
#10
Malgorzata Kobylecka, Monika Budnik, Janusz Kochanowski, Radoslaw Piatkowski, Marek Chojnowski, Katarzyna Fronczewska-Wieniawska, Tomasz Mazurek, Joanna Maczewska, Michał Peller, Grzegorz Opolski, Leszek Krolicki
BACKGROUND: The aim of this study was to assess the accumulation pattern of 18F-FDG in fasting patients with takotsubo cardiomyopathy (TTC) and to correlate the results with perfusion scintigraphy and echocardiography. METHODS: 18 consecutive patients with TTC were identified by clinical symptoms, cardiac catheterization, and echocardiography. Coronary angiography (CA) and transthoracic echocardiography (TTE) were performed on the day of the onset of symptoms. An assessment of myocardial perfusion (99mTc-MIBI) and glucose metabolism (18F-FDG) was performed within 18 days...
January 4, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28045326/non-occlusive-mesenteric-ischaemia-in-out-of-hospital-cardiac-arrest-survivors
#11
Raphael Wurm, Anna Cho, Henrike Arfsten, Raphael van Tulder, Christian Wallmüller, Philipp Steininger, Fritz Sterz, Kristina Tendl, Csilla Balassy, Klaus Distelmaier, Martin Hülsmann, Gottfried Heinz, Christopher Adlbrecht
BACKGROUND AND AIM OF THE STUDY: Non-occlusive mesenteric ischaemia (NOMI) is characterised by hypoperfusion of the intestines without evidence of mechanical obstruction, potentially leading to extensive ischaemia and necrosis. Low cardiac output appears to be a major risk factor. Cardiopulmonary resuscitation aims at restoring blood flow after cardiac arrest. However, post restoration of spontaneous circulation, myocardial stunning limits immediate recovery of sufficient cardiac function...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27875730/contemporary-review-on-the-pathogenesis-of-takotsubo-syndrome-the-heart-shedding-tears-norepinephrine-churn-and-foam-at-the-cardiac-sympathetic-nerve-terminals
#12
REVIEW
Shams Y-Hassan, Rodney De Palma
Takotsubo syndrome (TS), an increasingly recognized acute cardiac disease entity, is characterized by a unique pattern of circumferential and typically regional left ventricular wall motion abnormality resulting in a conspicuous transient ballooning of the left ventricle during systole. The mechanism of the disease remains elusive. However, the sudden onset of acute myocardial stunning in a systematic pattern extending beyond a coronary artery territory; the history of a preceding emotional or physical stress factor in two thirds of cases; the signs of sympathetic denervation at the regions of left ventricular dysfunction on sympathetic scintigraphy; the finding of myocardial edema and other signs consistent with (catecholamine-induced) myocarditis shown by cardiac magnetic resonance imaging; and the contraction band necrosis on histopathological examination all argue strongly for the involvement of the cardiac sympathetic nervous system in the pathogenesis of TS...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27866393/potentially-pathogenic-circulating-autoantibodies-to-cardiac-troponin-are-present-in-hemodialysis-patients
#13
Helen J Jefferies, Risto Tertti, Saara Wittfooth, James O Burton, Kaj Metsärinne, Kim Pettersson, Christopher W McIntyre
Introduction Repetitive dialysis-induced cardiac injury is associated with elevated troponin levels, inflammation, and longitudinal reduction in cardiac function. Pathogenic autoantibodies to cardiac troponins (cTnAAb) produce inflammatory cardiomyopathy in murine models. This study aimed to explore the possibility that analogous autoimmune processes might occur in hemodialysis (HD) patients, by initially investigating cTnAAb prevalence, and exploring potential links with HD-induced myocardial stunning. Methods In 130 prevalent HD patients from two centers (Derby, UK; Turku, Finland), cTnAAb (immunoassay) and cardiac troponins were quantified...
November 20, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27772642/intensive-hemodialysis-and-treatment-complications-and%C3%A2-tolerability
#14
Jose A Morfin, Richard J Fluck, Eric D Weinhandl, Sheru Kansal, Peter A McCullough, Paul Komenda
Hemodialysis (HD) treatment can be difficult to tolerate. Common complications are intradialytic hypotension (IDH) and long time to recovery after an HD session. IDH, as defined by nadir systolic blood pressure < 90mmHg and intradialytic decline > 30mmHg, occurs in almost 8% of HD sessions. IDH may be caused by aggressive ultrafiltration in response to interdialytic weight gain, can lead to myocardial stunning and cardiac arrhythmias, and is associated with increased risk for death. Long recovery time after a treatment session is also common...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27741040/citric-acid-cycle-metabolites-predict-the-severity-of-myocardial-stunning-and-mortality-in-newborn-pigs
#15
Janus Adler Hyldebrandt, Nicolaj Brejnholt Støttrup, Christian Alcaraz Frederiksen, Johan Heiberg, Rune Isak Dupont Birkler, Mogens Johannsen, Michael Rahbek Schmidt, Hanne Berg Ravn
OBJECTIVES: Myocardial infarction and chronic heart failure induce specific metabolic changes in the neonatal myocardium that are closely correlated to outcome. The aim of this study was to examine the metabolic responses to noninfarct heart failure and inotropic treatments in the newborn heart, which so far are undetermined. DESIGN: A total of 28 newborn pigs were instrumented with a microdialysis catheter in the right ventricle, and intercellular citric acid cycle intermediates and adenosine metabolite concentrations were determined at 20-minute intervals...
December 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27721951/diastolic-dyssynchrony-in-acute-st-segment-elevation-myocardial-infarction-and-relationship-with-functional-recovery-of-left-ventricle
#16
Burak Turan, Tolga Daşli, Ayhan Erkol, İsmail Erden, Yelda Başaran
BACKGROUND: Incidence of diastolic dyssynchrony (DD) and its impact on functional recovery of left ventricle (LV) after ST segment elevation myocardial infarction (STEMI) is not known. METHODS: Consecutive patients with STEMI who underwent successful revascularization were prospectively enrolled. Echocardiography with tissue Doppler imaging was performed within 48 hours of admission and at 6 months. LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), ejection fraction (EF), and left atrial volume index (LAVI) were calculated...
September 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27694035/absence-of-post-extrasystolic-potentiation-in-takotsubo-cardiomyopathy-another-piece-of-the-puzzle
#17
Shunsuke Aoi, Naoki Misumida, Blase Carabello, Maurice Rachko
BACKGROUND: Takotsubo cardiomyopathy (TCM) is an intriguing phenomenon characterized by transient and reversible left ventricular (LV) dysfunction despite angiographically unobstructed coronary arteries. The detailed pathophysiology of stunned, viable myocardium in TCM remains to be determined. Post-extrasystolic potentiation (PESP), the phenomenon of enhanced LV contractility following extrasystole, has been used to assess myocardial viability. METHODS: Utilizing a local database, we identified 74 cases that met the modified Mayo Clinic criteria for TCM between October 2004 and March 2016...
December 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27638024/takotsubo-syndrome-and-embolic-events
#18
REVIEW
Ibrahim El-Battrawy, Martin Borggrefe, Ibrahim Akin
Takotsubo cardiomyopathy (TTC), initially defined as a benign disease, is associated with several complications. One of them is a thromboembolism, which is clinically presented by events such as stroke, ventricular thrombi, and peripheral embolization, and can be present at index event of TCC as well as at any time in disease course. Patients with elevated C-reactive protein levels, markedly elevated D-dimers and severely impaired left ventricular function seem to be at higher risk of developing thrombemboli...
October 2016: Heart Failure Clinics
https://www.readbyqxmd.com/read/27638019/the-sympathetic-nervous-system-in-the-pathogenesis-of-takotsubo-syndrome
#19
REVIEW
Ilan S Wittstein
Takotsubo syndrome is a unique clinical condition of acute heart failure and reversible left ventricular dysfunction frequently precipitated by sudden emotional or physical stress. There is growing evidence that exaggerated sympathetic stimulation is central to the pathogenesis of this syndrome. Precisely how catecholamines mediate myocardial stunning in takotsubo syndrome remains incompletely understood; but possible mechanisms include epicardial spasm, microvascular dysfunction, direct adrenergic-receptor-mediated myocyte injury, and systemic vascular effects that alter ventricular-arterial coupling...
October 2016: Heart Failure Clinics
https://www.readbyqxmd.com/read/27581345/impact-of-malignancies-in-the-early-and-late-time-course-of-takotsubo-cardiomyopathy
#20
Mélanie Girardey, Laurence Jesel, Umberto Campia, Nathan Messas, Sébastien Hess, Alessio Imperiale, Cyrille Blondet, Annie Trinh, Patrick Ohlmann, Olivier Morel
BACKGROUND: Although the relationship between malignancies and catecholamine-induced myocardial stunning remains largely speculative, it has been suggested that the presence of cancer may lower the threshold for stress stimuli and/or may aggravate cardiac adrenoreceptor sensitivity. We sought to investigate whether associations exist between a previous or current diagnosis of malignancy, diagnostic parameters during hospitalization and death in takotsubo. METHODS AND RESULTS: The 154 takotsubo patients were retrospectively identified between May 2008 and December 2014...
September 23, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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