Right Ventricular Takotsubo Cardiomyopathy

Coronary Care Unit, University School of Medicine, Clinical Center of Serbia, Cardiology Clinic and Emergency Hospital, Belgrade, Serbia.
Journal of the American College of Cardiology (Impact Factor: 16.5). 04/2010; 55(16):1751. DOI: 10.1016/j.jacc.2009.02.098
Source: PubMed
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Available from: Igor Mrdovic
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    • "Since MPI is an estimate of systolic as well as diastolic ventricular function it has been shown to be a sensitive marker for ventricular function [7]. Previous case reports of TSC have shown that both the left and right ventricle have been affected, hence, it was of interest to study not only LV-MPI but also RV-MPI [18]–[20]. "
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    ABSTRACT: Due to the frequent use of coronary angiography the awareness of Takotsubo stress cardiomyopathy (TSC) has increased although the exact pathophysiology of TSC is still largely unknown. Our objective was to investigate the effects of mental stress on myocardial function, heart rate variability (HRV) and salivary cortisol (SC) in TSC patients. This study is a case-control study and a sub-study of the Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. Mental stress test was performed more than 6 months after the acute event in TSC patients and age- and sex-matched controls. Standard echocardiography and tissue Doppler imaging (TDI) - derived time-phases of cardiac cycle were recorded to calculate myocardial performance index (MPI) to assess ventricular function before and during mental stress. Holter-ECG recording was made to estimate HRV before, during and after mental stress. SC was measured at baseline, before and 20 minutes after mental stress. Twenty-two TSC patients and 22 sex-and age-matched controls were recruited from the SMINC-study and investigated with a mental stress test. All TSC patients had a previous normal cardiovascular magnetic resonance investigation. There were no significant differences at rest or during mental stress for left and right ventricular MPI or other standard diastolic variables between TSC patients and controls. HRV did not differ between TSC patients and controls. There was a trend towards less increase in SC after mental stress in TSC patients compared to controls. Mental stress did not induce a significant difference in myocardial function or HRV response between TSC and controls. Moreover, no significant difference could be seen in SC response at baseline, during or after mental stress. This study indicates that myocardial vulnerability to mental stress does not persist in TSC patients.
    Full-text · Article · Apr 2014 · PLoS ONE
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    • "Additionally, isolated RV Takotsubo cardiomyopathy may represent a distinct manifestation compared with LV Takotsubo cardiomyopathy, including acute right heart failure (3). Unfortunately, cases with isolated RV involvement are rarely reported (3,12). Therefore, further verification is required by additional observations in the future. "
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    ABSTRACT: We report a case of Takotsubo cardiomyopathy, which involved the right ventricle at first presentation and demonstrated involvement of the left ventricle during recurrence. The patient was admitted to Kyung Hee University Hospital due to a left hip fracture, which was considered a result of physical stress. Complete recovery was confirmed by echocardiography prior to recurrence. The cause of the second event was surgery for the left hip fracture. Recurrence of Takotsubo cardiomyopathy at various cardiac locations provides evidence against the existing hypotheses that variants of Takotsubo cardiomyopathy are associated with anatomically different distributions of cardiac adrenergic receptors, the degree of stimulation by sympathetic activity and different susceptibilities to such sympathetic stimulation.
    Full-text · Article · Jul 2013 · Experimental and therapeutic medicine

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