1
|
Manfredini R, Fabbian F, De Giorgi A, Cappadona R, Zucchi B, Storari A, Rodriguez Borrego MA, Carmona Torres JM, Lopez Soto PJ. Takotsubo syndrome and dialysis: an uncommon association? J Int Med Res 2018; 46:4399-4406. [PMID: 30178683 PMCID: PMC6259368 DOI: 10.1177/0300060518794249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This review was performed to investigate the association between treatment with dialysis and Takotsubo syndrome in patients with end-stage renal disease. We systematically explored the PubMed database using the search terms "Takotsubo cardiomyopathy" and/or "stress-induced cardiomyopathy" and/or "Takotsubo syndrome" in combination with "dialysis" and "uremia." Of 3630 articles found, 8 articles reporting 10 cases were selected for analysis. Most patients were women, and their age ranged from 51 to 84 years. Diabetes mellitus and hypertension were diagnosed in 40% of patients, and glomerular disease was diagnosed in 30%. One only patient was treated with peritoneal dialysis; all others were treated with hemodialysis. The outcome was unfavorable in only one patient. An association between Takotsubo syndrome and dialysis is uncommon, but not negligible, and comorbidities play a major role in determining the clinical outcome.
Collapse
Affiliation(s)
- Roberto Manfredini
- 1 Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Italy.,2 Azienda Ospedaliera-Universitaria, Ferrara, Italy.,3 Instituto Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), University of Cordoba, Spain
| | - Fabio Fabbian
- 1 Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Italy.,2 Azienda Ospedaliera-Universitaria, Ferrara, Italy.,3 Instituto Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), University of Cordoba, Spain
| | | | - Rosaria Cappadona
- 1 Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Italy
| | - Beatrice Zucchi
- 1 Faculty of Medicine, Pharmacy and Prevention, University of Ferrara, Italy
| | - Alda Storari
- 2 Azienda Ospedaliera-Universitaria, Ferrara, Italy
| | | | | | - Pablo Jesus Lopez Soto
- 3 Instituto Maimonides de Investigacion Biomedica de Cordoba (IMIBIC), University of Cordoba, Spain
| |
Collapse
|
2
|
Cappelletti S, Ciallella C, Aromatario M, Ashrafian H, Harding S, Athanasiou T. Takotsubo Cardiomyopathy and Sepsis. Angiology 2016; 68:288-303. [PMID: 27303068 DOI: 10.1177/0003319716653886] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Takotsubo cardiomyopathy (TTC) is characterized by a systolic dysfunction localized in the apical and medial aspect of the left ventricle. It is usually related to physical or emotional stress. Recent evidence highlighting the role of infection led us to analyze the links between TTC and sepsis. A systematic review of the literature was undertaken to assess any trends in clinical findings, diagnosis, and outcomes in such patients. We identified 23 selected papers reporting a total of 26 patients, having sepsis, in whom TTC occurred. For each case, we collected data identifying population characteristics, source of sepsis, clinical disease description, and the results of cardiovascular investigations. The majority of patients were females (n = 16), mean age was 62.8 (14.0 standard deviation) years, and clinical outcome was favorable in 92.3% of the cases once the management of sepsis was initiated. A better understanding of the mechanisms of sepsis-associated TTC may generate novel strategies to treat the complications of this cardiomyopathy and may even help predict and prevent its occurrence.
Collapse
Affiliation(s)
- Simone Cappelletti
- 1 Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy.,2 Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | - Costantino Ciallella
- 1 Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Mariarosaria Aromatario
- 1 Department of Anatomical, Histological, Forensic Medicine and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Hutan Ashrafian
- 2 Department of Surgery and Cancer, Imperial College London, London, United Kingdom.,3 Department of Cardiothoracic Surgery, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Sian Harding
- 4 Myocardial Function Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Thanos Athanasiou
- 2 Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| |
Collapse
|
3
|
Y-Hassan S. Acute, repetitive and chronic Takotsubo syndrome in patients with chronic kidney disease: Sympathetic reno-cardial syndrome. Int J Cardiol 2016; 222:874-880. [PMID: 27522391 DOI: 10.1016/j.ijcard.2016.07.278] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 07/18/2016] [Accepted: 07/30/2016] [Indexed: 02/07/2023]
Abstract
Heart failure and cardiovascular death are common in patients with chronic kidney disease (CKD) and extremely prevalent in patients undergoing dialysis. It has been shown that the excess of cardiovascular mortality in this patient population is not fully accounted for by the traditional cardiovascular risk factors. Substantial evidence exists for the presence of sympathetic over-activity in patients with dialytic and non-dialytic CKD. Several studies have also been reported on reversible segmental left ventricular wall motion abnormality consistent with myocardial stunning in association with dialysis especially hemodialysis. In the literature, the most acceptable underpinning hypothesis for the myocardial stunning in CKD is "demand myocardial ischemia". However, the occurrence of cardiac sympathetic over-activation-disruption and repeated reversible myocardial stunning in patients with CKD can be compared to that occurring in acute Takotsubo syndrome where local cardiac sympathetic disruption may cause acute regional circumferential pattern of myocardial stunning. In this manuscript, converging evidences suggestive for the fact that acute, repetitive, and chronic TS may be one of the important causes of cardiac morbidity including myocardial stunning and heart failure and mortality in patients with CKD are provided.
Collapse
Affiliation(s)
- Shams Y-Hassan
- Karolinska University Hospital, Huddinge, Department of Cardiology, S-141 86 Stockholm, Sweden.
| |
Collapse
|
4
|
Santoro F, Ferraretti A, Ieva R, Musaico F, Fanelli M, Tarantino N, Scarcia M, Caldarola P, Di Biase M, Brunetti ND. Renal impairment and outcome in patients with takotsubo cardiomyopathy. Am J Emerg Med 2016; 34:548-52. [DOI: 10.1016/j.ajem.2015.12.065] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 12/20/2015] [Accepted: 12/22/2015] [Indexed: 12/31/2022] Open
|
5
|
De Giorgi A, Fabbian F, Pala M, Parisi C, Misurati E, Molino C, Boccafogli A, Tiseo R, Gamberini S, Salmi R, Portaluppi F, Manfredini R. Takotsubo Cardiomyopathy and Acute Infectious Diseases. Angiology 2014; 66:257-61. [DOI: 10.1177/0003319714523673] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Takotsubo cardiomyopathy (TTC), also defined as “stress cardiomyopathy,” is characterized by a systolic dysfunction localized in the apical and medial left ventricles. Takotsubo cardiomyopathy is more prevalent in females and it is usually related to an event triggered by physical or emotional stress. We systematically explored PubMed and Embase medical information source to identify case reports showing association between infection and TTC. For each kind of infection, we collected a set of data, including pathogen, site of infection, clinical outcome, patient age and sex, and author and year of publication. We found 26 articles dealing with 27 case reports (74% women). The mean age was 61.4 ± 13.7 years and bacterial infections were more frequent (n = 23, 85.2%). In 14 cases, there was a culture-based definition of the bacterial strain: gram+ in 8 cases (57.1%) and gram− in 6 cases (42.9%). Clinical outcome was always favorable.
Collapse
Affiliation(s)
- Alfredo De Giorgi
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Fabio Fabbian
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Marco Pala
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Claudia Parisi
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Elisa Misurati
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Christian Molino
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Arrigo Boccafogli
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Ruana Tiseo
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Susanna Gamberini
- Second Internal Medicine, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | - Raffaella Salmi
- Second Internal Medicine, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| | | | - Roberto Manfredini
- Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Ferrara, Italy
| |
Collapse
|
6
|
Biventricular Takotsubo syndrome in a patient with coronary abnormality and end-stage renal disease. COR ET VASA 2013. [DOI: 10.1016/j.crvasa.2012.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
7
|
Abstract
Takotsubo cardiomyopathy (TTC) is an increasingly recognized, reversible cardiomyopathy with a clinical presentation that mimics an acute coronary syndrome but without evidence of obstructive coronary lesions. Typical presentation involves chest pain and/or dyspnea, transient ST-segment elevation on the electrocardiogram, and a modest increase in cardiac troponin. Cardiac imaging demonstrates wall-motion abnormalities that extend beyond the territory of a single epicardial coronary artery, and the absence of obstructive coronary lesions. Supportive treatment leads to spontaneous, rapid recovery of ventricular function, but about 10% of patients have recurrent events. This article reviews the defining features and clinical profile of TTC.
Collapse
|