Pathophysiology of Takotsubo syndrome: JACC state-of-the-art review
File(s)
Supporting information
Author(s)
Type
Journal Article
Abstract
Takotsubo syndrome (TTS) has been a recognized clinical entity for 31 years, since its first description in 1990. TTS is now routinely diagnosed in patients who present with acute chest pain, electrocardiographic changes, troponin elevation, unobstructed coronary arteries, and a typical pattern of circumferential left ventricular wall motion abnormalities that usually involve the apical and midventricular myocardium. Increasing understanding of this intriguing syndrome stems from wider recognition, possible increasing frequency, and a rising number of publications focused on the pathophysiology in clinical and laboratory studies. A comprehensive understanding of TTS pathophysiology and evidence-based treatments are lacking, and specific and effective treatments are urgently required. This paper reviews the pathophysiology of this fascinating syndrome; what is known from both clinical and preclinical studies, including review of the evidence for microvascular dysfunction, myocardial beta-adrenergic signaling, inflammation, and electrophysiology; and where focused research needs to fill gaps in understanding TTS.
Date Issued
2021-02-23
Date Acceptance
2020-10-19
Citation
Journal of the American College of Cardiology, 2021, 77 (7), pp.902-921
ISSN
0735-1097
Publisher
Elsevier
Start Page
902
End Page
921
Journal / Book Title
Journal of the American College of Cardiology
Volume
77
Issue
7
Copyright Statement
© 2021 Published by Elsevier on behalf of the American College of Cardiology Foundation. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/33602474
PII: S0735-1097(20)38133-X
Subjects
Takotsubo stunning
Takotsubo syndrome
catecholamines
inflammation
pathophysiology
stress
β-adrenergic signaling
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-02-15