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Argo A, Pitingaro W, Puntarello M, Buscemi R, Malta G, D’Anna T, Albano GD, Zerbo S. A Comprehensive Review on Alcohol Abuse Disorder Fatality, from Alcohol Binges to Alcoholic Cardiomyopathy. Diagnostics (Basel) 2024; 14:1189. [PMID: 38893715 PMCID: PMC11172201 DOI: 10.3390/diagnostics14111189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/20/2024] [Accepted: 05/30/2024] [Indexed: 06/21/2024] Open
Abstract
Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome", linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.
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Affiliation(s)
- Antonina Argo
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties “Giuseppe D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (W.P.); (M.P.); (R.B.); (T.D.); (G.D.A.); (S.Z.)
| | | | | | | | - Ginevra Malta
- Department of Health Promotion Sciences, Maternal and Child Care, Internal Medicine and Medical Specialties “Giuseppe D’Alessandro”, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy; (W.P.); (M.P.); (R.B.); (T.D.); (G.D.A.); (S.Z.)
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Rawashdeh B, Yaghmour N, Sulieman D, Abuassi M, Cooper M. Takotsubo cardiomyopathy after solid organ transplantation: a scoping review. Ann Med Surg (Lond) 2024; 86:2883-2891. [PMID: 38694296 PMCID: PMC11060263 DOI: 10.1097/ms9.0000000000002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/24/2024] [Indexed: 05/04/2024] Open
Abstract
Takotsubo syndrome (TTS) is a stress-induced cardiomyopathy that causes temporary left ventricular wall motion abnormalities and abrupt reversible heart failure. The incidence of perioperative TTS is proportional to the severity of surgical trauma, the duration of the procedure, and the degree of apparent sympathetic activity. A growing number of articles have discussed TTS after a solid organ transplant (SOT), which is one of the circumstances in which physical and emotional stress are at their highest levels. The majority of published cases involved patients who had received an orthotopic liver transplant (OLT). TTS occurred in 0.3-1.7% of liver transplant recipients, but a limited number of cases of TTS in patients who had received kidney, heart, or lung transplants have also been documented. In this study, we analyzed the TTS instances that developed after SOT, highlighting the symptoms and causes as well as the various treatment approaches that were applied. Most TTS cases following OLT and kidney transplant cases occurred in the first week of the surgery. However, the majority of cases occurred years after heart transplantation. Dizziness, dyspnoea, and chest discomfort are the most typical symptoms. Patients may also experience syncope and generalized weakness. In spite of this, the symptoms differ depending on the transplanted organ. Dyspnoea is a common symptom after lung transplants, whereas chest discomfort and dizziness are a common symptom after liver and kidney transplants. Yet, chest pain is not a typical symptom after a heart transplant.
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Affiliation(s)
- Badi Rawashdeh
- Medical College of Wisconsin, Division of Transplant Surgery, Milwaukee, WI
| | | | | | | | - Matthew Cooper
- Medical College of Wisconsin, Division of Transplant Surgery, Milwaukee, WI
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Farjoud Kouhanjani M, Hosseini SA, Mousavi SM, Noroozi Z, Sadeghi P, Jokar-Derisi A, Jamshidi Mouselou MS, Ahmadi M, Attar A. Takotsubo Cardiomyopathy and Autoimmune Disorders: A Systematic Scoping Review of Published Cases. Int J Clin Pract 2024; 2024:7259200. [PMID: 38414580 PMCID: PMC10898954 DOI: 10.1155/2024/7259200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction Takotsubo cardiomyopathy (TCM) features transient left ventricular apical dysfunction or ballooning. The underlying mechanism remains elusive; however, evidence suggests the role of different physical and psychological stressors. We systematically reviewed patients presenting with TCM and autoimmunity to explore the link between the two conditions. Methods We applied the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) to report this review. Using keywords related to autoimmune/immune-mediated diseases and TCM, we searched PubMed, Scopus, and WOS in March 2022. The final results were added to a data extraction sheet. Data were analyzed by SPSS version 26.0. Results Our search yielded 121 studies, including 155 patients. Females were considerably predominant. Most patients had a history of autoimmune disease, and almost a third had a history of cardiovascular disease. Dyspnea and chest pain were the most common chief complaints. More than 70% of patients had experienced physical stress. Myasthenia gravis, systemic lupus erythematosus, and multiple sclerosis were the most frequently reported autoimmune diseases. Conclusion There were similarities in age and sex compared to classic TCM. TCM should be considered as a differential diagnosis for ACS, especially in patients with a positive background of autoimmunity. A precise reporting system is required for further studies.
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Affiliation(s)
- Mohsen Farjoud Kouhanjani
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Zahra Noroozi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Paniz Sadeghi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Armita Jokar-Derisi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Meysam Ahmadi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Armin Attar
- Department of Cardiology, School of Medicine, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Dong F, Yin L, Sisakian H, Hakobyan T, Jeong LS, Joshi H, Hoff E, Chandler S, Srivastava G, Jabir AR, Kimball K, Chen YR, Chen CL, Kang PT, Shabani P, Shockling L, Pucci T, Kegecik K, Kolz C, Jia Z, Chilian WM, Ohanyan V. Takotsubo syndrome is a coronary microvascular disease: experimental evidence. Eur Heart J 2023; 44:2244-2253. [PMID: 37170610 PMCID: PMC10290875 DOI: 10.1093/eurheartj/ehad274] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 02/08/2023] [Accepted: 04/26/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND AND AIMS Takotsubo syndrome (TTS) is a conundrum without consensus about the cause. In a murine model of coronary microvascular dysfunction (CMD), abnormalities in myocardial perfusion played a key role in the development of TTS. METHODS AND RESULTS Vascular Kv1.5 channels connect coronary blood flow to myocardial metabolism and their deletion mimics the phenotype of CMD. To determine if TTS is related to CMD, wild-type (WT), Kv1.5-/-, and TgKv1.5-/- (Kv1.5-/- with smooth muscle-specific expression Kv1.5 channels) mice were studied following transaortic constriction (TAC). Measurements of left ventricular (LV) fractional shortening (FS) in base and apex, and myocardial blood flow (MBF) were completed with standard and contrast echocardiography. Ribonucleic Acid deep sequencing was performed on LV apex and base from WT and Kv1.5-/- (control and TAC). Changes in gene expression were confirmed by real-time-polymerase chain reaction. MBF was increased with chromonar or by smooth muscle expression of Kv1.5 channels in the TgKv1.5-/-. TAC-induced systolic apical ballooning in Kv1.5-/-, shown as negative FS (P < 0.05 vs. base), which was not observed in WT, Kv1.5-/- with chromonar, or TgKv1.5-/-. Following TAC in Kv1.5-/-, MBF was lower in LV apex than in base. Increasing MBF with either chromonar or in TgKv1.5-/- normalized perfusion and function between LV apex and base (P = NS). Some genetic changes during TTS were reversed by chromonar, suggesting these were independent of TAC and more related to TTS. CONCLUSION Abnormalities in flow regulation between the LV apex and base cause TTS. When perfusion is normalized between the two regions, normal ventricular function is restored.
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Affiliation(s)
- Feng Dong
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Liya Yin
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Hamayak Sisakian
- Department of Cardiology, Yerevan State Medical University, Yerevan, Kentron, Armenia
| | - Tatevik Hakobyan
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Lacey S Jeong
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Hirva Joshi
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Ellianna Hoff
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Selena Chandler
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Geetika Srivastava
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Abdur Rahman Jabir
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Kelly Kimball
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Yeong-Renn Chen
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Chwen-Lih Chen
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Patrick T Kang
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Parisa Shabani
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Lindsay Shockling
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Thomas Pucci
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Karlina Kegecik
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Christopher Kolz
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Zhenyu Jia
- Department of Botany and Plant Sciences, University of California, Riverside, CA, USA
| | - William M Chilian
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
| | - Vahagn Ohanyan
- Department of Integrative Medical Sciences, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, Ohio 44272, USA
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Bachayev M, Brereton B, Mondal A, Alli-Ramsaroop BA, Dhakal R, Leon MCB, Quinones CM, Abdelal MEO, Jain A, Dhaduk K, Desai R. Takotsubo Syndrome in Orthotopic Liver Transplant: A Systematic Review and Pooled Analysis of Published Studies and Case Reports. Transplant Proc 2023:S0041-1345(22)00778-3. [PMID: 36858907 DOI: 10.1016/j.transproceed.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/05/2022] [Accepted: 11/16/2022] [Indexed: 03/03/2023]
Abstract
BACKGROUND Takotsubo syndrome (TTS) has been reported in solid-organ transplant recipients. However, the pooled data regarding TTS after liver transplant remain limited. METHODS A systematic review was performed through February 2022 using PubMed, Embase, Scopus, and Google Scholar to review case reports/series and original studies on liver transplant-associated TTS. Descriptive analysis was performed for case reports and pooled analysis for the prevalence using random effects models. RESULTS A total of 56 case reports were included from 30 articles (51.8 % male; mean age, 53 years; India 56%, US 27%, and Europe 8.93%) and 10 original studies (US 88.65%, India 10.92%) revealing liver transplant-associated TTS. The pooled prevalence of TTS was 1.1% (95% Cl, 0.6%-1.7%) of all liver transplants with comparable rates in studies from India and the US (P = .92). Indications for liver transplant included end-stage liver disease due to alcohol-related cirrhosis (25%), hepatitis C virus infection (17.9%), hepatocellular carcinoma (10.7%), and non-alcohol-related steatohepatitis (8.9%); the average Model for End-Stage Liver Disease score was 24.75. TTS commonly presented as hypotension (30%), dyspnea (14%), and oliguria, occurring mostly post-transplant (82%), whereas 14% were intraoperative. Common electrocardiogram findings were ST changes, ventricular tachycardia, and atrial fibrillation. Common echocardiogram findings showed left ventricular apical ballooning in 46.5% of cases and reduced ejection fraction < 20% in 41.9% of cases. Common complications were cardiogenic shock (32.1 %), acute kidney injury (12.5%), arrhythmia, stroke, cardiac arrest, and hepatic artery thrombosis. Mechanical circulatory support was required in 30.3%. Recurrence was reported in 15, and mortality in 30.4% of patients. CONCLUSIONS Takotsubo syndrome prevalence after liver transplant is significantly higher than TTS prevalence in general US hospitalizations with potentially worse outcomes. Prospective registries reporting TTS in liver transplant recipients are warranted.
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Affiliation(s)
- Milana Bachayev
- Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis
| | - Brian Brereton
- Department of Medicine, Jersey General Hospital, Saint Helier, Jersey
| | - Avilash Mondal
- Department of Internal Medicine, Nazareth Hospital, Philadelphia, Pennsylvania
| | | | - Roshan Dhakal
- Department of Medicine, Nepal Medical College, Kathmandu, Nepal
| | - Maria C Buhl Leon
- Department of Medicine, Universidad de San Martin de Porres, Lima, Peru
| | - Camila M Quinones
- Department of Medicine, Universidad de San Martin de Porres, Lima, Peru
| | - Mohamed Eyad O Abdelal
- Department of Medicine, International University of the Health Sciences, St. Kitts, Nevis
| | - Akhil Jain
- Department of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Kartik Dhaduk
- Department of Internal Medicine, Geisinger Wyoming Valley Medical Center, Wilkes Barre, Pennsylvania.
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Yang J, Rao Z, Hong F, Agopian V, Nguyen-Lee J, Steadman RH, Wray C, Xia VW. Takotsubo Syndrome after Liver Transplantation: An Association with Intraoperatively Administered Epinephrine and Fentanyl. Clin Transplant 2021; 35:e14463. [PMID: 34403157 DOI: 10.1111/ctr.14463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/04/2021] [Accepted: 08/13/2021] [Indexed: 12/01/2022]
Abstract
Takotsubo syndrome (TTS) can develop after liver transplant (LT), but its predisposing factors are poorly understood. In this study, we aimed to determine if perioperative factors were associated with posttransplant TTS. Adult patients who underwent primary LT between 2006 and 2018 were included. Patients with and without TTS were identified and matched by propensity scores. Of 2181 LT patients, 38 developed postoperative TTS with a mean left ventricular ejection fraction of 25.5% (±7.8%). Multivariable logistic regression revealed two preoperative risk factors (alcoholic cirrhosis and model for end-stage liver disease-sodium scores) for TTS. Post-propensity match analyses showed that TTS patients had significantly higher doses of epinephrine and lower doses of fentanyl during LT compared with non-TTS patients. A higher dose of epinephrine and a lower dose of fentanyl wasere associated with a higher predicted probability of TTS. All TTS patients had full recovery of cardiac function and had comparable one-year survival. In conclusion, TTS occurred inat a rate of 1.7% after LT and was associated with two pretransplant risk factors. The higher doses of epinephrine and lower doses of fentanyl administered during LT were associated with posttransplant TTS. More studies on the relationship between intraoperative medications and TTS are warranted. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jun Yang
- Department of Critical Care Medicine, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Zhuqing Rao
- Department of Anesthesiology, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fu Hong
- Department of Anesthesiology, Chongqing University Central Hospital, Chongqing, China
| | - Vatche Agopian
- Department of Surgery, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jennifer Nguyen-Lee
- Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Randolph H Steadman
- Department of Anesthesiology and Critical Care, Houston Methodist Hospital, Houston, TX, USA
| | - Christopher Wray
- Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Victor W Xia
- Department of Anesthesiology and Perioperative Medicine, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Caballol B, Reverter E, Cid J, Hernández-Tejero M, Triolo M, Lozano M, Fernández J. Fulminant hepatitis A complicated by Takotsubo syndrome successfully treated with standard volume plasma exchange. JHEP Rep 2019; 1:445-448. [PMID: 32039396 PMCID: PMC7005653 DOI: 10.1016/j.jhepr.2019.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/03/2019] [Accepted: 10/18/2019] [Indexed: 02/06/2023] Open
Abstract
Fulminant hepatic failure is an unusual complication of hepatitis A virus infection which, without liver transplantation, is associated with a poor prognosis. We report a case of fulminant hepatitis A complicated by severe cardiac dysfunction, related to Takotsubo syndrome, that was considered a contraindication for transplantation and was successfully managed with standard volume plasma exchange.
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Affiliation(s)
- Berta Caballol
- Liver ICU, Liver Unit, IMDiM, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Enric Reverter
- Liver ICU, Liver Unit, IMDiM, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Joan Cid
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | | | - Michela Triolo
- Liver ICU, Liver Unit, IMDiM, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain
| | - Miquel Lozano
- Apheresis & Cellular Therapy Unit, Department of Hemotherapy and Hemostasis, ICMHO, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Javier Fernández
- Liver ICU, Liver Unit, IMDiM, Hospital Clínic, IDIBAPS and CIBERehd, Barcelona, Spain.,EF Clif, EASL-CLIF Consortium and Grifols Chair, Barcelona, Spain
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