Abstract
Takotsubo cardiomyopathy (TC) is a condition most prevalent in postmenopausal women, characterized by transient left ventricular dysfunction following acute emotional or physical stress. Direct catecholamine-mediated myocyte injury and microvascular dysfunction leading to myocardial stunning are believed to play a major role in its pathogenesis. The treatment of TC remains empirical. In the acute phase, therapy must be individualized depending on hemodynamic situation. In stable conditions, it appears advantageous to prevent excessive sympathetic activation by combining alpha and beta blockade. Beta blockers are used to treat dynamic left ventricular obstruction. Phenylephrine may represent an alternative approach in patients presenting with outflow tract obstruction and severe hypotension. In hemodynamically unstable patients, early administration of intra-aortic balloon pump counterpulsation should be considered. As no consensus currently exists with respect to the chronic management of TC, randomized clinical trials are urgently needed with focus on treatment strategies.
Keywords: Takotsubo cardiomyopathy, transient left ventricular dysfunction, catecholamine-mediated injury, left ventricular outflow tract obstruction, beta blockers, Phenylephrine, hemodynamic situation, transient apical ballooning, broken heart, ampulla-syndrome, hypokinesis, akinesis, dyskinesis, cardiac troponin, pheochromocytoma, myocarditis, hypertrophic cardiomyopathy, dyspnoea, pulmonary oedema, cardiogenic shock, ventricular arrhythmias, hypovolemia, metaiodobenylguanidine, subarachnoid hemorrhage, Catecholamines, aspirin, heparin, ventriculography, intra-aortic balloon counterpulsation, Inotropes, coronary atherosclerosis
Current Pharmaceutical Design
Title: Treatment of Takotsubo Cardiomyopathy
Volume: 16 Issue: 26
Author(s): Tomas Palecek, Petr Kuchynka and Ales Linhart
Affiliation:
Keywords: Takotsubo cardiomyopathy, transient left ventricular dysfunction, catecholamine-mediated injury, left ventricular outflow tract obstruction, beta blockers, Phenylephrine, hemodynamic situation, transient apical ballooning, broken heart, ampulla-syndrome, hypokinesis, akinesis, dyskinesis, cardiac troponin, pheochromocytoma, myocarditis, hypertrophic cardiomyopathy, dyspnoea, pulmonary oedema, cardiogenic shock, ventricular arrhythmias, hypovolemia, metaiodobenylguanidine, subarachnoid hemorrhage, Catecholamines, aspirin, heparin, ventriculography, intra-aortic balloon counterpulsation, Inotropes, coronary atherosclerosis
Abstract: Takotsubo cardiomyopathy (TC) is a condition most prevalent in postmenopausal women, characterized by transient left ventricular dysfunction following acute emotional or physical stress. Direct catecholamine-mediated myocyte injury and microvascular dysfunction leading to myocardial stunning are believed to play a major role in its pathogenesis. The treatment of TC remains empirical. In the acute phase, therapy must be individualized depending on hemodynamic situation. In stable conditions, it appears advantageous to prevent excessive sympathetic activation by combining alpha and beta blockade. Beta blockers are used to treat dynamic left ventricular obstruction. Phenylephrine may represent an alternative approach in patients presenting with outflow tract obstruction and severe hypotension. In hemodynamically unstable patients, early administration of intra-aortic balloon pump counterpulsation should be considered. As no consensus currently exists with respect to the chronic management of TC, randomized clinical trials are urgently needed with focus on treatment strategies.
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Cite this article as:
Palecek Tomas, Kuchynka Petr and Linhart Ales, Treatment of Takotsubo Cardiomyopathy, Current Pharmaceutical Design 2010; 16 (26) . https://dx.doi.org/10.2174/138161210793176455
DOI https://dx.doi.org/10.2174/138161210793176455 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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