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Tan B, Chen L, Yan S, Pan H, Zhang J, Wei H. Risk of stress cardiomyopathy associated with selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors: a real-world pharmacovigilance analysis. Sci Rep 2024; 14:15167. [PMID: 38956425 PMCID: PMC11220088 DOI: 10.1038/s41598-024-66155-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are reported to cause stress cardiomyopathy (SC). This study evaluated the association between SSRI/SNRI use and the occurrence of cardiomyopathy in the publicly available U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) database. Disproportionate analysis and likelihood ratio tests were used to identify risk associated with SSRIs or SNRIs and the incidence of SC, using data from between from 2012 to 2022 acquired from the FAERS database. The study identified 132 individual case safety reports (ICSRs) of SC associated with SSRIs or SNRIs. Venlafaxine (48%) and fluoxetine (27%) were the most common antidepressants of the ICSRs. Approximately 80% of SC cases were reported in females, with individuals aged 45-65 years identified as a high-risk population. Both venlafaxine (ratio-scale information component [RSIC] 2.54, 95% CI 2.06-3.04) and fluoxetine (RSIC 3.20, 95% CI 2.31-4.47) were associated with SC, with likelihood ratio estimates of 3.55 (p = 0.02) for venlafaxine and 4.82 (p = 0.008) for fluoxetine. The median time to cardiomyopathy onset was 20 days, with hospitalization reported in 48.33% of patients. Venlafaxine and fluoxetine were associated with SC risk, particularly in middle-aged women. Caution should be exercised when using SSRIs or SNRIs combined with other serotonergic medications.
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Affiliation(s)
- Boyu Tan
- Department of Pharmacy, Shanghai Children's Hospital, Children's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
- Department of Pharmacy, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Li Chen
- Department of Pharmacy, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Sulan Yan
- Department of Cardiology, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, People's Republic of China
| | - Huijie Pan
- Department of Pharmacy, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jingxian Zhang
- Department of Pharmacy, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Hongyan Wei
- Department of Pharmacy, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
- Institute of I Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, People's Republic of China.
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Heart and brain interactions : Pathophysiology and management of cardio-psycho-neurological disorders. Herz 2021; 46:138-149. [PMID: 33544152 PMCID: PMC7966144 DOI: 10.1007/s00059-021-05022-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 12/22/2022]
Abstract
Cardiovascular diseases (CVD) and mental health disorders (MHD; e.g. depression, anxiety and cognitive dysfunction) are highly prevalent and are associated with significant morbidity and mortality and impaired quality of life. Currently, possible interactions between pathophysiological mechanisms in MHD and CVD are rarely considered during the diagnostic work-up, prognostic assessment and treatment planning in patients with CVD, and research addressing bidirectional disease mechanisms in a systematic fashion is scarce. Besides some overarching pathogenetic principles shared by CVD and MHD, there are specific syndromes in which pre-existing neurological or psychiatric illness predisposes and contributes to CVD development (as in Takotsubo syndrome), or in which the distorted interplay between innate immune and central nervous systems and/or pre-existing CVD leads to secondary MHD and brain damage (as in peripartum cardiomyopathy or atrial fibrillation). Clinical manifestations and phenotypes of cardio-psycho-neurological diseases depend on the individual somatic, psychosocial, and genetic risk profile as well as on personal resilience, and differ in many respects between men and women. In this article, we provide arguments on why, in such conditions, multidisciplinary collaborations should be established to allow for more comprehensive understanding of the pathophysiology as well as appropriate and targeted diagnosis and treatment. In addition, we summarize current knowledge on the complex interactions between the cardiovascular and central nervous systems in Takotsubo syndrome and peripartum cardiomyopathy, and on the neurological and psychiatric complications of atrial fibrillation.
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Ong GJ, Nguyen TH, Stansborough J, Surikow S, Mahadavan G, Worthley M, Horowitz J. The N-AcetylCysteine and RAMipril in Takotsubo Syndrome Trial (NACRAM): Rationale and design of a randomised controlled trial of sequential N-Acetylcysteine and ramipril for the management of Takotsubo Syndrome. Contemp Clin Trials 2020; 90:105894. [PMID: 31740426 DOI: 10.1016/j.cct.2019.105894] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Takotsubo Syndrome(TTS), contrary to historical reports, is now increasingly recognised to be associated with substantial mortality and morbidity, both in the short- and long-term. Although TTS is often precipitated by a catecholamine "pulse", in-hospital hypotension is a common occurrence, increasing the risk of mortality. Furthermore, despite the transient catecholamine stimulus, there is increasing evidence that there are significant long term sequelae, including persistently impaired left ventricular(LV) systolic dysfunction, myocardial oedema with fibrosis, as well as persistent impairment of quality of life. A definitive therapeutic option to limit the extent of initial myocardial injury, and to accelerate recovery in TTS is therefore justified. However to date, there has been a lack of prospective studies in this area. DESIGN AND RATIONALE NACRAM is a multi-centre, randomised, placebo-controlled trial, sequentially testing early use of intravenous N-acetylcysteine(NAC), followed by/or oral ramipril for 12 weeks. The rationale for utilising these agents is related to their effects on limiting nitrosative stress and expression of the inflammasome activator thioredoxin interacting protein(TXNIP); both processes fundamental to the pathogenesis of TTS. END POINTS NACRAM is assessing resolution of myocardial oedema on cardiac magnetic resonance imaging(CMR), improvements in LV systolic function as measured by global longitudinal strain(GLS) on echocardiography, quality of life, and inflammatory markers. DISCUSSION To the best of our knowledge, NACRAM will be the first prospective study to help definitively evaluate a therapeutic option in acute attacks of TTS.
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Affiliation(s)
- Gao Jing Ong
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia; Cardiology Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Thanh Ha Nguyen
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia
| | | | - Sven Surikow
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia
| | - Gnanadevan Mahadavan
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia; Cardiology Unit, Royal Adelaide Hospital, Adelaide, SA, Australia; Cardiology Unit, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
| | - Matthew Worthley
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia; Cardiology Unit, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - John Horowitz
- Cardiology Unit, Queen Elizabeth Hospital, Woodville, SA, Australia; University of Adelaide, Basil Hetzel Institute, Woodville, SA, Australia.
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Ong GJ, Nguyen TH, Stansborough J, Surikow SY, Horowitz JD. Incremental “Therapeutic” Myocardial Exposure to Catecholamines: Incidence and Impact in Takotsubo Syndrome. Cardiovasc Drugs Ther 2020; 34:95-100. [DOI: 10.1007/s10557-019-06918-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Zvonarev V. Takotsubo Cardiomyopathy: Medical and Psychiatric Aspects. Role of Psychotropic Medications in the Treatment of Adults with "Broken Heart" Syndrome. Cureus 2019; 11:e5177. [PMID: 31423403 PMCID: PMC6695293 DOI: 10.7759/cureus.5177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Takotsubo cardiomyopathy (TTC) is reversible stress-induced cardiomyopathy featuring symptoms of acute myocardial infarction without significant coronary artery abnormalities. TTC is frequently precipitated by stressful emotional events but it also has been reported as a result of substance withdrawal, non-cardiac events, and dangerous drug-to-drug interaction. The plasma levels of both epinephrine and norepinephrine were significantly elevated in TTC patients, suggesting that elevated catecholamine levels might be the main contributing factor. However, the mechanisms underlying susceptibility to development and recurrence are not completely understood. It has been suggested that even a therapeutic dose of antidepressant could be a cause of drug-induced tachycardia and TTC. Moreover, some cases have been reported in which the development of TTC was associated with the serotonin syndrome, neuroleptic malignant syndrome, and similar fatal consequences. The aim of this article is to explore the association between underlying psychiatric disorders and TTC and to determine the role of various psychotropic medications in the progression of stress-induced cardiomyopathy. This article also notes and discusses the current theories underlying the pathophysiology of TTC. This review suggests a serious side effect of antidepressants, and to avoid life-threatening cardiovascular events, such as TTC, for patients with affective and anxiety disorders, prior screening for cardiovascular conditions by ECG with close monitoring might be necessary.
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Affiliation(s)
- Valeriy Zvonarev
- School of Behavioral Sciences, California Southern University, Costa Mesa, USA
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Frequently Recurrent Takotsubo Syndrome in COPD. Case Rep Cardiol 2019; 2019:6706935. [PMID: 30729044 PMCID: PMC6343172 DOI: 10.1155/2019/6706935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/04/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease is common among patients with chronic obstructive pulmonary disease (COPD). Takotsubo syndrome (TTS) is a transient cardiac disorder that, in its typical form, involves left ventricular dysfunction with apical ballooning and mimics acute coronary syndrome (ACS). “Bronchogenic TTS” has been proposed as a specific form of TTS (during severe acute dyspnea in asthma or COPD) with atypical presentation. Recurrent TTS in COPD seems to be exceptionally rare since only a handful of clinical cases have previously been reported in the literature. Here, we present a unique case of a frequently recurrent TTS during COPD exacerbation in a 70-year-old woman, with at least 4 different episodes of TTS within 5 years. This case report exemplifies the difficulties of the diagnosis of TTS at the onset of acute COPD exacerbation. Potential pathophysiological mechanisms and therapeutic strategies are also briefly discussed.
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Dias A, Núñez Gil IJ, Santoro F, Madias JE, Pelliccia F, Brunetti ND, Salmoirago-Blotcher E, Sharkey SW, Eitel I, Akashi YJ, El-Battrawy I, Franco E, Akin I, Jaguszewski M, Dawson D, Figueredo VM, Napp LC, Christensen TE, Hebert K, Ben-Dor I, Ozaki Y, García-Garcia HM, Kajita AH, Akasaka T, Kurisu S, Lerman A, Waksman R. Takotsubo syndrome: State-of-the-art review by an expert panel - Part 1. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 20:70-79. [PMID: 30528096 DOI: 10.1016/j.carrev.2018.11.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 11/14/2018] [Indexed: 12/30/2022]
Abstract
Takotsubo syndrome (TTS) is an acute cardiac condition independent of epicardial coronary obstruction that mimics acute coronary syndrome and is characterized by acute heart failure with reversible ventricular motion abnormalities. This consensus paper is the result of a multinational effort aiming to summarize the current state of the art on TTS. Experts in the field provide a thorough and detailed review of this syndrome. Several novel and unique sections are emphasized in this document, including the current state of the art on genetics of takotsubo syndrome, microRNAs (miRs), racial differences, role of cardiac spectroscopy and intracoronary imaging, as well as mechanical circulatory support. In part 1 of this two-part manuscript, we discuss how TTS came to be known, several patterns and forms it can take in patients, epidemiology and pathophysiology of the syndrome, and clinical presentation.
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Affiliation(s)
- Andre Dias
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America; Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States of America
| | - Ivan J Núñez Gil
- Interventional Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain
| | - Francesco Santoro
- Department of Medical & Surgery Sciences, University of Foggia, Foggia, Italy
| | - John E Madias
- Icahn School of Medicine at Mount Sinai/Division of Cardiology, Elmhurst Hospital Center, Elmhurst, NY, United States of America
| | | | | | - Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Scott W Sharkey
- Minneapolis Heart Institute Foundation, Minneapolis, MN, United States of America
| | - Ingo Eitel
- Cardiology, Angiology, Intensive Care Medicine, University Lübeck, Schleswig-Holstein, Germany
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Ibrahim El-Battrawy
- Department of Internal Medicine, University Heidelberg, Mannheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Germany
| | - Emiliana Franco
- Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States of America
| | - Ibrahim Akin
- Department of Internal Medicine, University Heidelberg, Mannheim, Germany; DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Germany
| | | | - Dana Dawson
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
| | - Vincent M Figueredo
- Department of Cardiology, Einstein Medical Center, Philadelphia, PA, United States of America
| | - L Christian Napp
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | | | - Kathy Hebert
- GE Healthcare, Miami, FL, United States of America
| | - Itsik Ben-Dor
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Yuichi Ozaki
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Héctor M García-Garcia
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Alexandre H Kajita
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Satoshi Kurisu
- Department of Cardiovascular Medicine, Hiroshima University, Hiroshima, Japan
| | - Amir Lerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
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Woronow D, Suggs C, Levin R, Diak IL, Kortepeter C. Reply: Catecholamine-Mediated Pathways in Takotsubo Syndrome: Does it Matter If it Is a Serotonin Norepinephrine Reuptake Inhibitor or a Selective Serotonin Reuptake Inhibitor? JACC. HEART FAILURE 2018; 6:721-722. [PMID: 30071954 DOI: 10.1016/j.jchf.2018.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 06/08/2023]
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Nayeri A, Rafla-Yuan E, Krishnan S, Ziaeian B, Cadeiras M, McPherson JA, Wells QS. Psychiatric Illness in Takotsubo (Stress) Cardiomyopathy: A Review. PSYCHOSOMATICS 2018; 59:220-226. [PMID: 29544664 PMCID: PMC7652383 DOI: 10.1016/j.psym.2018.01.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Takotsubo cardiomyopathy (TC), also known as stress-induced cardiomyopathy, has been increasingly described in relation to psychiatric illness. METHODS We performed a literature review to identify the key findings related to psychiatric illness in TC that may be relevant to the practice of mental health and other health care providers. RESULTS The association of psychiatric illness with TC in addition to the spectrum of psychiatric illness found in TC, the role of exacerbation or treatment of psychiatric illness in triggering TC, different modes of presentation, prognostic implications, and long-term management of psychiatric illness in TC are discussed. Additionally, we review the limitations of the pre-existing literature and suggest areas of future research. CONCLUSIONS There is a strong association between pre-existing psychiatric illness, particularly anxiety and mood spectrum disorders, and TC. Acute exacerbation of psychiatric illness, rapid uptitration or overdose of certain psychotropic agents, and electroconvulsive therapy may trigger TC. Further studies are needed to better evaluate the prognostic significance and long-term management of psychiatric illness in TC.
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Affiliation(s)
- Arash Nayeri
- Department of Medicine, University of California, Los Angeles, CA.
| | - Eric Rafla-Yuan
- Department of Psychiatry, University of California, San Diego, CA
| | | | - Boback Ziaeian
- Department of Medicine, University of California, Los Angeles, CA
| | - Martin Cadeiras
- Department of Medicine, University of California, Los Angeles, CA
| | - John A McPherson
- Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Quinn S Wells
- Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
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Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy. PSYCHOSOMATICS 2017; 58:527-532. [PMID: 28602445 DOI: 10.1016/j.psym.2017.04.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 04/17/2017] [Accepted: 04/18/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND The increased prevalence of psychiatric illness among patients with takotsubo cardiomyopathy (TC) has been previously described. OBJECTIVES We sought to assess the effect of pre-existing psychiatric illness on clinical outcomes following the diagnosis of TC. METHODS Adults diagnosed with TC at Vanderbilt University Medical Center between 1999 and 2015 were included in the study. Medical records were retrospectively reviewed to identify any pre-existing mood, anxiety, or schizophrenia-spectrum illness before TC presentation. Multivariable logistic regression was used to test for independent association of pre-existing psychiatric illness with 30-day mortality and recurrent TC; Cox proportional hazard analysis was used to evaluate for association with long-term mortality. RESULTS Among 306 patients diagnosed with TC during the study period, 114 (37%) had a pre-existing psychiatric illness. In all, 43 (14%) and 88 (29%) patients died within 30 days of index diagnosis and as of last medical record review, respectively. Of the 269 who survived their index hospitalization, 19 (7%) had a confirmed recurrent episode of TC. In multivariable analyses, pre-existing psychiatric illness was not associated with increased 30-day (P = 0.320) or long-term (P = 0.621) mortality. Pre-existing psychiatric illness was associated with higher risk of recurrent TC (odds ratio = 7.44, 95% CI: 2.30-24.01, P < 0.001). CONCLUSIONS Pre-existing psychiatric illness was associated with an increased risk of recurrent TC. No significant association was noted between pre-existing psychiatric illness and survival.
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Abstract
Takotsubo cardiomyopathy, also known as Takotsubo syndrome (TTS), is a cardiac syndrome first described in Japan in 1990 that typically follows an acute physical or psychiatric stressor, hence its association with the terms "broken heart syndrome" and stress cardiomyopathy. Although it is relatively rare, occurring in only 0.02% of the general population and roughly 2% of patients with acute coronary syndrome, neurological or psychiatric disorders are present in over 50% of affected individuals. One of the major hypotheses regarding the pathophysiology of TTS involves a catecholamine surge, from stress directly, or in some cases from psychiatric medication used to relieve distress. Given the association of TTS with acute stress and psychiatric illness, psychiatrists may be involved in the care of patients with TTS either at the initial presentation of the condition or following recovery. The case reports presented in this issue exemplify these 2 scenarios: one case involves the development of TTS during treatment with atomoxetine, and the other case involves treatment of depression in a patient after recovery from TTS, as well as a TTS recurrence during treatment with fluoxetine.
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Pereira VH, Marques P, Magalhães R, Português J, Calvo L, Cerqueira JJ, Sousa N. Central autonomic nervous system response to autonomic challenges is altered in patients with a previous episode of Takotsubo cardiomyopathy. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2015; 5:152-63. [DOI: 10.1177/2048872615568968] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 01/02/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Vitor H Pereira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Cardiology Department, Alto Ave Hospital Centre, Guimarães, Portugal
| | - Paulo Marques
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ricardo Magalhães
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - João Português
- Cardiology Department, Alto Ave Hospital Centre, Guimarães, Portugal
| | - Lucy Calvo
- Cardiology Department, Alto Ave Hospital Centre, Guimarães, Portugal
| | - João J Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B’s – PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Yoneyama K, Akashi YJ. Letter regarding the article "Growth differentiation factor-15 in takotsubo cardiomyopathy: diagnostic and prognostic value". Int J Cardiol 2014; 176:515. [PMID: 25056449 DOI: 10.1016/j.ijcard.2014.07.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Kihei Yoneyama
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
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