Патофизиологические аспекты развития синдрома Такоцубо
Ключевые слова:
кардиомиопатия, острый коронарный синдром, ишемическая болезнь сердца, катехоламины, вазоспазмАннотация
Кардиомиопатия Такоцубо составляет 1% до 3% случаев острого коронарного синдрома от 0,5% до 0,9% случаев инфаркта миокарда с подъёмом сегмента ST. Частота возникновения кардиомиопатии Такоцубо значительно возросла во время пандемии COVID-19. Клиническое течение заболевания, как правило, доброкачественное, но может закончиться опасными для жизни осложнениями, такими, как кардиогенный шок и остановка сердца. Но до сих пор однозначных патофизиологических аспектов этого заболевания не установлено, имеется множество исследований, посвященной этой патологии.
В этой обзорной статье мы описываем опубликованные данные о потенциальных, основных механизмах, связанных с возникновением кардиомиопатии Такоцубо. Эти патомеханизмы позволяют предположить новые оптимальные терапевтические стратегии у пациентов с кардиомиопатией Такоцубо.
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Библиографические ссылки
Ghadri, J. R., Wittstein, I. S., Prasad, A., Sharkey, S., Dote, K., Akashi, Y. J., Templin, C. (2018). International expert
consensus document on Takotsubo syndrome (part I): clinical characteristics, diagnostic criteria, and pathophysiology. European heart journal, 39(22), 2032-2046. https://doi.org/10.1093/eurheartj/ehy076
Ghadri, J. R., Cammann, V. L., Jurisic, S., Seifert, B., Napp, L. C., Diekmann, J., Bax, J. J. (2017). A novel clinical score
(InterTAK Diagnostic Score) to differentiate takotsubo syndrome from acute coronary syndrome: results from the International Takotsubo Registry. European journal of heart failure, 19(8), 1036-1042. https://doi.org/10.1002/ejhf.683
Matta, A., Roncalli, J., Elbaz, M., Lhermusier, T., Campelo-Parada, F., Bouisset, F., Carrié, D. (2020). Mid-ventricular
takotsubo cardiomyopathy with hawk’s beak appearance: A case report. The American journal of case reports, 21, e919563.
https://doi.org/10.12659/AJCR.919563
Redfors, B., Jha, S., Thorleifsson, S., Jernberg, T., Angerås, O., Frobert, O., Omerovic, E. (2021). Short-and long-term clinical
outcomes for patients with takotsubo syndrome and patients with myocardial infarction: a report from the Swedish coronary angiography and angioplasty registry. Journal of the American Heart Association, 10(17), e017290. https://doi.org/10.1161/JAHA.119.017290
Uribarri, A., Núñez-Gil, I. J., Conty, D. A., Vedia, O., Almendro-Delia, M., Duran Cambra, A., RETAKO Investigators. (2019).
Short-and long-term prognosis of patients with Takotsubo syndrome based on different triggers: importance of the physical nature. Journal of the American Heart Association, 8(24), e013701. https://doi.org/10.1161/JAHA.119.013701
Ghadri, J. R., Kato, K., Cammann, V. L., Gili, S., Jurisic, S., Di Vece, D., Templin, C. (2018). Long-term prognosis of patients with Takotsubo syndrome. Journal of the American College of Cardiology, 72(8), 874-882. https://doi.org/10.1016/j.jacc.2018.06.016
Naegele M., Flammer A., Enseleit F., Roas S., Frank M., Hirt A., Kaiser P., Cantatore S., Templin C., Fröhlich G., Romanens
M., Lüscher T., Ruschitzka F., Noll G., Sudano I. Endothelial function and sympathetic nervous system activity in patients with Takotsubo syndrome. Int J Cardiol. 2016 Dec 1;224:226-230. https://doi.org/10.1016/j.ijcard.2016.09.008
Pelliccia, F., Kaski, J. C., Crea, F., Camici, P. G. (2017). Pathophysiology of Takotsubo syndrome. Circulation, 135(24),
-2441. https://doi.org/10.1161/CIRCULATIONAHA.116.027121
Templin, C., Ghadri, J. R., Diekmann, J., Napp, L. C., Bataiosu, D. R., Jaguszewski, M., Lüscher, T. F. (2015). Clinical
features and outcomes of takotsubo (stress) cardiomyopathy. New England Journal of Medicine, 373(10), 929-938. https://doi.org/10.1056/NEJMoa1406761
Agdamag, A. C., Patel, H., Chandra, S., Rao, A., Suboc, T. M., Marinescu, K., Volgman, A. S. (2020). Sex differences in
takotsubo syndrome: a narrative review. Journal of Women's Health, 29(8), 1122-1130. https://doi.org/10.1089/jwh.2019.7741
Khera, R., Light-McGroary, K., Zahr, F., Horwitz, P. A., Girotra, S. (2016). Trends in hospitalization for takotsubo
cardiomyopathy in the United States. American heart journal, 172, 53-63. https://doi.org/10.1016/j.ahj.2015.10.022
Weidner, K. J., El-Battrawy, I., Behnes, M., Schramm, K., Fastner, C., Kuschyk, J., Akin, I. (2017). Sex differences of
in-hospital outcome and long-term mortality in patients with Takotsubo cardiomyopathy. Therapeutics and Clinical Risk
Management, 863-869. https://doi.org/10.2147/TCRM.S131760
Murakami, T., Yoshikawa, T., Maekawa, Y., Ueda, T., Isogai, T., Sakata, K., Takayama, M. (2015). Gender differences in
patients with takotsubo cardiomyopathy: multi-center registry from Tokyo CCU Network. PloS one, 10(8), e0136655. https://
doi.org/10.1371/journal.pone.0136655
Budnik, M., Nowak, R., Fijałkowski, M., Kochanowski, J., Nargiełło, E., Piątkowski, R., Opolski, G. (2020). Sex-dependent
differences in clinical characteristics and in-hospital outcomes in patients with takotsubo syndrome. Pol Arch Intern Med, 130(1), 25-30. https://doi.org/10.20452/pamw.14970
Maskoun, W., Alqam, B., Habash, F., Gheith, Z., Sawada, S. G., Vallurupalli, S. (2023). Sex differences in stress-induced
(takotsubo) cardiomyopathy. CJC open, 5(2), 120-127. https://doi.org/10.1016/j.cjco.2022.11.012
Arcari, L., Nunez-Gil, I. J., Stiermaier, T., El-Battrawy, I., Guerra, F., Novo, G., Santoro, F. (2022). Gender differences
in takotsubo syndrome. Journal of the American College of Cardiology, 79(21), 2085-2093. https://doi.org/10.1016/J.
JACC.2022.03.366
Gili, S., Cammann, V. L., Schlossbauer, S. A., Kato, K., D’Ascenzo, F., Di Vece, D., Templin, C. (2019). Cardiac arrest in
takotsubo syndrome: results from the InterTAK Registry. European heart journal, 40(26), 2142-2151. https://doi.org/10.1093/eurheartj/ehz170
Jabri, A., Kalra, A., Kumar, A., Alameh, A., Adroja, S., Bashir, H., Reed, G. W. (2020). Incidence of stress cardiomyopathy
during the coronavirus disease 2019 pandemic. JAMA network open, 3(7), e2014780-e2014780. https://doi.org/10.1001/
jamanetworkopen.2020.14780
Eftekharzadeh, P., Patel, A., Sokolova, E., Rodas, A., Ahmed, S., Sokolova, E. Y. (2022). Takotsubo cardiomyopathy: a
COVID-19 complication. Cureus, 14(3). https://doi.org/10.7759/cureus.22803
Ahmed, S. K., Mohamed, M. G., Essa, R. A., Dabou, E. A. A. R., Abdulqadir, S. O., Omar, R. M. (2022). Global reports
of takotsubo (stress) cardiomyopathy following COVID-19 vaccination: a systematic review and meta-analysis. IJC Heart
Vasculature, 43, 101108. https://doi.org/10.1016/j.ijcha.2022.101108
Fazlollahi, A., Zahmatyar, M., Noori, M., Nejadghaderi, S. A., Sullman, M. J., Shekarriz-Foumani, R., Safiri, S. (2022).
Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series. Reviews in
medical virology, 32(4), e2318. https://doi.org/10.1002/rmv.2318
Hasan, S. M., Patel, J. D., Faluk, M., Patel, J., Singh, P. (2020). Takotsubo cardiomyopathy and its variants: a case series
and literature review. Journal of Community Hospital Internal Medicine Perspectives, 10(3), 210-215. https://doi.org/10.1080/20009666.2020.1767271
Boyd, B., Solh, T. (2020). Takotsubo cardiomyopathy: review of broken heart syndrome. Jaapa, 33(3), 24-29. https://doi.org/10.1097/01.JAA.0000654368.35241.fc
Amin, H. Z., Amin, L. Z., Pradipta, A. (2020). Takotsubo cardiomyopathy: a brief review. Journal of medicine and life,
(1), 3. https://doi.org/10.25122/jml-2018-0067
Mizutani, K., Shioya, A., Hirose, Y., Saito, R., Yamada, S. (2020). Serious takotsubo cardiomyopathy: an autopsy case
presenting severe irreversible myocardial damage after frequent episodes of recurrence. Diagnostic Pathology, 15, 1-5. https://doi.org/10.1186/s13000-020-01006-x
Rivero, F., Cuesta, J., García-Guimaraes, M., Bastante, T., Alvarado, T., Antuña, P., Alfonso, F. (2017). Time-related
microcirculatory dysfunction in patients with Takotsubo cardiomyopathy. JAMA cardiology, 2(6), 699-700. https://doi.org/10.1001/jamacardio.2016.5993
Ghadri, J. R., Sarcon, A., Diekmann, J., Bataiosu, D. R., Cammann, V. L., Jurisic, S., Prasad, A. (2016). Happy heart
syndrome: role of positive emotional stress in takotsubo syndrome. European heart journal, 37(37), 2823-2829. https://doi.org/10.1093/eurheartj/ehv757
Shams, Y., Henareh, L. (2015). Plasma catecholamine levels in patients with takotsubo syndrome: implications for
the pathogenesis of the disease. International journal of cardiology, 181, 35-38. https://doi.org/10.1016/j.ijcard.2014.11.149
Nazir, S., Melnick, S., Lohani, S., Lloyd, B. (2016). Rare case of stress cardiomyopathy due to intramuscular epinephrine
administration. Case Reports, 2016, bcr2016215691. https://doi.org/10.1136/bcr-2016-215691
Chiang, Y. L., Chen, P. C., Lee, C. C., Chua, S. K. (2016). Adrenal pheochromocytoma presenting with Takotsubo-pattern
cardiomyopathy and acute heart failure: A case report and literature review. Medicine, 95(36), e4846. https://doi.org/10.1097/MD.0000000000004846
Y-Hassan, S., Falhammar, H. (2019). Pheochromocytoma-and paraganglioma-triggered Takotsubo syndrome.
Endocrine, 65(3), 483-493. https://doi.org/10.1007/s12020-019-02035-3
Christensen, T. E., Bang, L. E., Holmvang, L., Skovgaard, D. C., Oturai, D. B., Søholm, H., Hasbak, P. (2016). 123I-MIBG
scintigraphy in the subacute state of Takotsubo cardiomyopathy. JACC: Cardiovascular Imaging, 9(8), 982-990. https://doi.org/10.1016/j.jcmg.2016.01.028
Marfella, R., Barbieri, M., Sardu, C., Rizzo, M. R., Siniscalchi, M., Paolisso, P., Paolisso, G. (2016). Effects of α-lipoic acid
therapy on sympathetic heart innervation in patients with previous experience of transient takotsubo cardiomyopathy. Journal of cardiology, 67(2), 153-161. https://doi.org/10.1016/j.jjcc.2015.07.012
Templin, C., Manka, R., Cammann, V. L., Szawan, K. A., Gotschy, A., Karolyi, M., Ghadri, J. R. (2020). Takotsubo syndrome
in coronavirus disease 2019. The American journal of cardiology, 138, 118. https://doi.org/10.1016/j.amjcard.2020.10.005
Borchert, T., Hübscher, D., Guessoum, C. I., Lam, T. D. D., Ghadri, J. R., Schellinger, I. N., Streckfuss-Bömeke, K. (2017).
Catecholamine-dependent β-adrenergic signaling in a pluripotent stem cell model of takotsubo cardiomyopathy. Journal of the American College of Cardiology, 70(8), 975-991. https://doi.org/10.1016/j.jacc.2017.06.061
Brazdil, V., Kala, P., Hudec, M., Poloczek, M., Kanovsky, J., Stipal, R., Brazdil, M. (2022). The role of central autonomic
nervous system dysfunction in Takotsubo syndrome: a systematic review. Clinical Autonomic Research, 32(1), 9-17. https://doi.org/10.1007/s10286-021-00844-z
Münzel, T., Templin, C., Cammann, V. L., Hahad, O. (2021). Takotsubo Syndrome: Impact of endothelial dysfunction
and oxidative stress. Free Radical Biology and Medicine, 169, 216-223. https://doi.org/10.1016/j.freeradbiomed.2021.03.033
Li C., Li P., Peddibhotla B., Teng C., Shi A., Lu X., Cai P., Dai Q., Wang B. Takotsubo syndrome and vaccines: a systematic
review. ESC Heart Fail. 2024 Jun;11(3):1795-1801. https://doi.org/10.1002/ehf2.14719
Kato, K., Di Vece, D., Cammann, V. L., Micek, J., Szawan, K. A., Bacchi, B., InterTAK Collaborators. (2019). Takotsubo
recurrence: morphological types and triggers and identification of risk factors. Journal of the American College of Cardiology, 73(8), 982-984. https://doi.org/10.1016/j.jacc.2018.12.033
Radfar, A., Abohashem, S., Osborne, M. T., Wang, Y., Dar, T., Hassan, M. Z., Tawakol, A. (2021). Stress-associated
neurobiological activity associates with the risk for and timing of subsequent Takotsubo syndrome. European Heart Journal, 42(19), 1898-1908. https://doi.org/10.1093/eurheartj/ehab029
Hiestand, T., Hänggi, J., Klein, C., Topka, M. S., Jaguszewski, M., Ghadri, J. R., Templin, C. (2018). Takotsubo syndrome
associated with structural brain alterations of the limbic system. Journal of the American College of Cardiology, 71(7), 809-811. https://doi.org/10.1016/j.jacc.2017.12.022
Dichtl, W., Tuovinen, N., Barbieri, F., Adukauskaite, A., Senoner, T., Rubatscher, A., Steiger, R. (2020). Functional
neuroimaging in the acute phase of Takotsubo syndrome: volumetric and functional changes of the right insular cortex. Clinical Research in Cardiology, 109, 1107-1113. https://doi.org/10.1007/s00392-020-01602-3
Wang, X., Pei, J., Hu, X. (2020). The brain-heart connection in Takotsubo syndrome: The central nervous system,
sympathetic nervous system, and catecholamine overload. Cardiology research and practice, 2020(1), 4150291. https://doi.org/10.1155/2020/4150291
Y-Hassan, S., Falhammar, H. (2020). Clinical features, complications, and outcomes of exogenous and endogenous
catecholamine-triggered Takotsubo syndrome: a systematic review and meta-analysis of 156 published cases. Clinical Cardiology, 43(5), 459-467. https://doi.org/10.1002/clc.23352
Al-Tkrit, A., Mekaiel, A., Aneeb, M., Alawawdeh, F., Mangla, A. (2020). Left ventricular free wall rupture in broken-heart
syndrome: a fatal complication. Cureus, 12(11). https://doi.org/10.7759/cureus.11316
Cammann, V. L., Szawan, K. A., Stähli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Templin, C. (2020). Age-related
variations in Takotsubo syndrome. Journal of the American College of Cardiology, 75(16), 1869-1877. https://doi.org/10.1016/j.jacc.2020.02.057
Wischnewsky, M. B., Candreva, A., Bacchi, B., Cammann, V. L., Kato, K., Szawan, K. A., Templin, C. (2019). Prediction of
short-and long-term mortality in takotsubo syndrome: the InterTAK Prognostic Score. European journal of heart failure, 21(11), 1469-1472. https://doi.org/10.1002/ejhf.1561
Scally, C., Rudd, A., Mezincescu, A., Wilson, H., Srivanasan, J., Horgan, G., Dawson, D. K. (2018). Persistent long-term
structural, functional, and metabolic changes after stress-induced (Takotsubo) cardiomyopathy. Circulation, 137(10), 1039-
https://doi.org/10.1161/CIRCULATIONAHA.117.031841
Scally, C., Abbas, H., Ahearn, T., Srinivasan, J., Mezincescu, A., Rudd, A., Dawson, D. K. (2019). Myocardial and systemic
inflammation in acute stress-induced (Takotsubo) cardiomyopathy. Circulation, 139(13), 1581-1592. https://doi.org/10.1161/CIRCULATIONAHA.118.037975
Isogai, T., Matsui, H., Tanaka, H., Fushimi, K., Yasunaga, H. (2016). Early β-blocker use and in-hospital mortality in
patients with Takotsubo cardiomyopathy. Heart, 102(13), 1029-1035. https://doi.org/10.1136/heartjnl-2015-308712
Santoro, F., Stiermaier, T., Tarantino, N., De Gennaro, L., Moeller, C., Guastafierro, F., Eitel, I. (2017). Left
ventricular thrombi in Takotsubo syndrome: incidence, predictors, and management: results from the GEIST (German Italian Stress Cardiomyopathy) Registry. Journal of the American Heart Association, 6(12), e006990. https://doi.org/10.1161/JAHA.117.006990
D'Ascenzo, F., Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Templin, C. (2020). Impact of aspirin on
takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry. European journal of heart failure, 22(2), 330-337. https://doi.org/10.1002/ejhf.1698
Rizzetto, F., Lia, M., Widmann, M., Tavella, D., Zanolla, L., Pighi, M., Ribichini, F. L. (2022). Prognostic impact of
antiplatelet therapy in Takotsubo syndrome: a systematic review and meta-analysis of the literature. Heart Failure Reviews,
