MiscellaneousStress-Induced Hyperviscosity in the Pathophysiology of Takotsubo Cardiomyopathy
Section snippets
Methods
In the Department of Heart and Vessels, from January to December 2007, 17 patients (all women, aged 71 ± 12 years) with previous TC diagnosed according to the Mayo Clinic criteria, as previously reported,7 were included in the Tuscany Registry of TC and previously investigated.7 A stressful situation resulted in precipitating the event in 13 patients with TC, whose symptoms had been chest pain or dyspnea. ST-segment elevation in V1 to V3 leads followed by T-wave inversion was the most frequent
Results
No significant differences in the cardiovascular risk factors or baseline blood count parameters and fibrinogen values were found between the patients with TC and the controls. The hemorheologic and endothelial variables in the patients and controls before and after the CPT are listed in Table 1 and shown in Figure 1, Figure 2, Figure 3. At baseline, a significantly lower erythrocyte deformability index (p <0.05) and greater PAI-1 levels (p <0.05) were found in patients with previous TC
Discussion
This is the first study to analyze alterations in the hemorheologic and endothelial parameters induced by acute sympathetic stimulation in patients with previous TC.
The main finding of the present study was that patients with TC have, at baseline, an altered erythrocyte deformability and greater PAI-1 plasma levels compared to the controls. Moreover, these patients had, after sympathetic stimulation, an exaggerated response in terms of alterations in several hemorheologic parameters and in
Disclosures
The authors have no conflicts of interest to disclose.
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2020, Anaesthesia Critical Care and Pain MedicineCitation Excerpt :While it is true that most patients achieve complete recovery within 2–4 weeks, there is substantial morbidity and mortality in the acute phase of TS. Complications are often severe and include decompensated heart failure (50% of patients) [49], respiratory failure requiring intubation and mechanical ventilation, cardiogenic shock (4–20% of patients) requiring inotropic, vasopressor, and/or MCS [3], ventricular arrhythmias (44% of patients) [3], mitral regurgitation (14–25% of patients) [3], LV outflow obstruction (10–25% of patients) [50], intraventricular thrombus (up to 10% of patients) [51], and death. LV outflow obstruction can result from hyperkinesis of the basal LV wall, which frequently coincides with apical akinesis in typical TS.
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