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Specifics in the ECG diagnosis of takotsubo syndrome. Int J Cardiol 2024:132140. [PMID: 38705204 DOI: 10.1016/j.ijcard.2024.132140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
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2
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Comment on: "Sex differences in patients presenting with acute coronary syndrome: a state-of-the-art review". Curr Probl Cardiol 2024; 49:102522. [PMID: 38492613 DOI: 10.1016/j.cpcardiol.2024.102522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024]
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3
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Frequent POCUS and auscultation for an earlier diagnosis of takotsubo syndrome and unraveling of its pathophysiology: The possible crucial role of LVOTO. Curr Probl Cardiol 2024; 49:102482. [PMID: 38401826 DOI: 10.1016/j.cpcardiol.2024.102482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
There is ample literature associating LVOTO with hypertension, AMI, LV hypertrophy, sigmoid septum, HCM, and TTS, particularly in midde aged/elderly/postmenopausal women, suggestive of a causal role for LVOTO in the pathophysiology of TTS. Although there is significant evidence that TTS is triggered by a sudden autonomic sympathetic nervous system surge and/or elevated blood-ridden catecholamines, the exact pathophysiologic trajectory leading to the clinical expression of the disease is still being debated. This review expounds on the possibility that LVOTO is a causal early component of this trajectory, and proposes that TTS is a malady within the broad spectrum of the myocardial ischemic injury/stunned myocardium states. The postulated underlying mechanism by which LVOTO causes TTS is a sudden abterload rise, with resultant oxygen/energy supply/demand mismatch, leading to a transient myocardial ischemia/injury myocardial stunning state. This needs to be explored painstakingly, and this review includes some suggestions for such undertaking. Ellucidation of the pathophysiology of TTS, and possible proof about a mechanistic role of LVOTO, may ensure that our current pharmacological and device panoply is adequate for the management of TTS.
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A protocol for the diagnosis/management of takotsubo syndrome in patients with neurological pathologies or undergoing neurosurgery. Childs Nerv Syst 2024; 40:1327-1328. [PMID: 38470511 DOI: 10.1007/s00381-024-06362-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Accepted: 03/07/2024] [Indexed: 03/14/2024]
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5
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Takotsubo syndrome in the elderly: Frequent auscultation and POCUS. QJM 2024:hcae063. [PMID: 38684175 DOI: 10.1093/qjmed/hcae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Indexed: 05/02/2024] Open
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6
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Serial Home Blood Pressure and Heart Rate Measurements for Optimized Management. Am J Med 2024:S0002-9343(24)00208-0. [PMID: 38582323 DOI: 10.1016/j.amjmed.2024.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Serial blood pressure and heart rate measurements, particularly obtained by the patients at home, are currently recommended for the management of patients. METHODS Home blood pressure and heart rate measurements were obtained by an 81-year old husband and his 74-year old wife in the morning and evening, over the course of an entire month. RESULTS Morning and evening systolic blood pressure (129.9 ± 5.5, 125.9 ± 10.2, respectively), and diastolic blood pressure (69.2 ± 4.0, 70.1 ± 5.3) were not different (P > .05), heart rate (61.2 ± 2.9, 69.0 ± 5.5) was higher in the evening (P = .00001) in the husband, while systolic blood pressure (134.7 ± 9.6, 119.0 ± 12.0) and diastolic blood pressure (78.6 ± 5.6, 72.1 ± 7.3) were higher in the morning (P = .00001, P = .00031), and heart rate (62.7 ± 4.7, 68.2 ± 4.6) was higher in the evening (P = .00017) in the wife. CONCLUSIONS Patient-generated serial home blood pressure and heart rate logs provide essential data for the patients' management and could potentially be useful in research; circadian variation of blood pressure and heart rate calls for implementation of chronotherapeutic principles for the time of drug administration.
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The recurrence rate of takotsubo syndrome may be higher than currently reported. Curr Probl Cardiol 2024; 49:102413. [PMID: 38262504 DOI: 10.1016/j.cpcardiol.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
Various rates of the short- and long-term recurrence of takotsubo syndrome (TTS) (RTTS) have been reported, but the absence, or the short length of the follow-up implemented is such, that the true rate of RTTS continues to be unknown. Experience has shown that a sizeable proportion of patients with an index TTS suffer a RTTS episode beyond 5 years, and even 20 years later. In a cohort of 215 patients with RTTS from the world literature, a mean of 30.2 and 37.2 months separated the index TTS from the 1st and last RTTS episodes, respectively, with 21.9 % of patients suffering more than 1 RTTS episode, over a course of maximum of 20 years. Also, 39.5 % and 19.5 % of patients had their only or last RTTS episode(s), at or beyond the 3rd and 5th year of follow-up, respectively. The true rate of RTTS is unknown, probably is higher that currently reported, and it is hoped that existing registries may provide the answer, if they implement an open-ending long-term follow-up of their registered patients.
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How does electrocardiography-derived compare with angiography-derived coronary microcirculatory resistance index in patients with takotsubo syndrome? Clin Res Cardiol 2024:10.1007/s00392-024-02404-7. [PMID: 38381364 DOI: 10.1007/s00392-024-02404-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/13/2024] [Indexed: 02/22/2024]
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9
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Comments on "QT interval prolongation in Takotsubo syndrome: a frightening feature with no major prognostic impact". Monaldi Arch Chest Dis 2024. [PMID: 38299613 DOI: 10.4081/monaldi.2024.2879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 01/29/2024] [Indexed: 02/02/2024] Open
Abstract
Dear Editor, Pinho et al. reported on the acquired corrected QT-interval (QTc) prolongation in a retrospective analysis of 113 patients (aged 67.6±11.7, 94.7% female)...
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Further Evidence for a Global Myocardial Involvement and an Incomplete Recovery in Takotsubo Syndrome. Am J Cardiol 2024; 211:381. [PMID: 38042264 DOI: 10.1016/j.amjcard.2023.11.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 12/04/2023]
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11
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Is Pheochromocytoma-Induced Takotsubo Different From Typical Takotsubo Syndrome? Am J Cardiol 2024; 211:378-379. [PMID: 37923153 DOI: 10.1016/j.amjcard.2023.10.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/18/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
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Serial electrocardiograms at follow-up for early detection of transplanted heart rejection: A viewpoint. J Electrocardiol 2024; 82:136-140. [PMID: 38141486 DOI: 10.1016/j.jelectrocard.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 12/25/2023]
Abstract
This viewpoint proposed that serial electrocardiograms (ECG) could be used to monitor for heart transplantation (HT) rejection, based on the expected attenuation of the amplitude of ECG QRS complexes (attQRS) engendered by the rejection-induced decrease in electrical resistance due to the underlying myocardial edema (ME). Previous work in humans has shown attQRS in the setting of a diverse array of edematous states, affecting the myocardium (i.e, ME) and the body volume conductor "enveloping" the heart. Also, animal and human experience has revealed low electrical resistance during mild/moderate HT rejection. Studies with serial correlations of endomyocardial biopsy (EMB), echocardiography, cardiac magnetic resonance imaging, and ECG are recommended, which will merely require recording of an ECG, when EMB and imaging studies are carried out for monitoring of post-HT rejection.
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Inquiries about Tpe and ventricular arrhythmias in patients with takotsubo syndrome. Heart Rhythm O2 2024; 5:63. [PMID: 38312202 PMCID: PMC10837169 DOI: 10.1016/j.hroo.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
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Heightened risk of ischemic stroke and mortality in takotsubo syndrome: A function of what? Int J Cardiol 2023; 392:131348. [PMID: 37683770 DOI: 10.1016/j.ijcard.2023.131348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023]
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15
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Recurrence of Takotsubo Syndrome: The Puzzle Still Defies Solution. Am J Cardiol 2023; 207:521. [PMID: 37805283 DOI: 10.1016/j.amjcard.2023.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/14/2023] [Indexed: 10/09/2023]
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16
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Delving in the follow-up hemostatic changes in patients with Takotsubo syndrome. Int J Cardiol 2023; 391:131307. [PMID: 37652273 DOI: 10.1016/j.ijcard.2023.131307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023]
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17
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Correspondence on "Beta-blockers and renin-angiotensin system inhibitors for Takotsubo syndrome recurrence: a network meta-analysis" by Santoro et al. Heart 2023; 109:1795. [PMID: 37827553 DOI: 10.1136/heartjnl-2023-323430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
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18
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Sitting ECGs to diagnose chemotherapy-induced cardiomyopathy/heart failure. J Electrocardiol 2023; 81:167-168. [PMID: 37741270 DOI: 10.1016/j.jelectrocard.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
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A protocol to ascertain whether sepsis-induced cardiomyopathy constitutes a phenotype of Takotsubo syndrome. JOURNAL OF INTENSIVE MEDICINE 2023; 3:380-381. [PMID: 38028639 PMCID: PMC10658035 DOI: 10.1016/j.jointm.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 05/09/2023] [Accepted: 06/09/2023] [Indexed: 12/01/2023]
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The Mystery of Left Ventricular Ejection Fraction Recovery: A Possible Undiagnosed Takotsubo Syndrome? Am J Cardiol 2023; 205:520-521. [PMID: 37633793 DOI: 10.1016/j.amjcard.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/28/2023]
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21
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Coexistent spontaneous coronary artery dissection and takotsubo syndrome: does one cause the other? Egypt Heart J 2023; 75:84. [PMID: 37817003 PMCID: PMC10564687 DOI: 10.1186/s43044-023-00413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
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Absence of ST-Segment Elevation in Inferior and Lateral Leads in Patients With Complete Right Bundle Branch Block Is an Index of Underlying Cardiac Pathology. Am J Cardiol 2023; 203:362-367. [PMID: 37517132 DOI: 10.1016/j.amjcard.2023.07.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/10/2023] [Indexed: 08/01/2023]
Abstract
A recent report called attention to the nature of the ST-segment elevation (STSE) in some or all inferior and/or lateral electrocardiogram (ECG) leads (i.e., I, II, III, aVL, aVF, V5, and V6), which are frequently encountered in patients with stable or transient complete right bundle branch block (RBBB). These STSEs represent secondary repolarization changes due to late depolarization RBBB alterations; are stable over the course of many years in patients with RBBB; and do not reflect cardiac pathology, as the automated ECG interpretation algorithms erroneously indicate. Indeed, the absence of such STSEs in patients with RBBB suggests the presence of underlying acute or old myocardial infarction, acute myocardial ischemia, or left ventricular hypertrophy and thus constitute an as yet undescribed ECG index of cardiovascular pathology.
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Regional wall motion abnormalities in critically ill patients: How frequent is takotsubo syndrome? Acta Anaesthesiol Scand 2023; 67:1137. [PMID: 37211715 DOI: 10.1111/aas.14281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/29/2023] [Indexed: 05/23/2023]
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24
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Towards refining of the proposed ECG-based index of coronary microvascular resistance (ECGMVR). J Electrocardiol 2023; 80:111-118. [PMID: 37315487 DOI: 10.1016/j.jelectrocard.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 06/16/2023]
Abstract
Assessment of the coronary microcirculation via noninvasive indices of coronary microvascular resistance (MVR), based on coronary angiography (AngioMVR) is currently implemented in patients undergoing coronary angiography, and it is employed by many laboratories. Recently, a proposal has been presented of a new index of MVR, based on the duration of the transient electrocardiogram repolarization and depolarization changes emerging during coronary angiography (ECGMVR). It is paramount that the ECGMVR, which does not require any special expertise, new equipment, additional personnel and costs, or prolongation of the catheterization procedure, undergoes correlation with currently utilized indices of AngioMVR, the TIMI frame count index, and the invasive indices assessing the coronary epicardial and microvasculature states, for its validation. Some additional insights are also included in the present communication for the refinement of ECGMVR implementation.
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An Opportune Time to Consider Glucose-Insulin-Potassium Therapy for Takotsubo Syndrome. Am J Cardiovasc Drugs 2023; 23:467-470. [PMID: 37526886 DOI: 10.1007/s40256-023-00597-2] [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] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
This viewpoint takes the position that the management of takotsubo syndrome (TTS) should not wait the elucidation of the pathophysiology of this mysterious malady but should move along the direction currently implemented for acute coronary syndromes (ACS). Accordingly, and since there is a current rekindled interest in the salutary effect of glucose-insulin-potassium (GIK) for the management of acute myocardial infarction, and in general of the broad domain of ACS, it is the opinion of this author that it is an opportune time for the same therapeutic principles, including GIK, applied for the broad domain of suspected ACS (in view of the prospective phase 3 IMMEDIATE-2 trial), to be considered for TTS.
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Letter by Madias Regarding Article, "Recurrent Takotsubo Cardiomyopathy and Myocardial Infarction due to Aberrant Right Coronary Artery in a Patient With Nonobstructive Coronary Arteries". Circ Cardiovasc Imaging 2023; 16:e015435. [PMID: 37154029 DOI: 10.1161/circimaging.123.015435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Concurrence of acute myocardial infarction and takotsubo syndrome: speculations about its prevalence and mechanism. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023:10.1007/s10554-023-02848-4. [PMID: 37149502 DOI: 10.1007/s10554-023-02848-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 03/27/2023] [Indexed: 05/08/2023]
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Letter by Madias Regarding Article, "Manganese-Enhanced Magnetic Resonance Imaging in Takotsubo Syndrome". Circulation 2023; 147:1414-1415. [PMID: 37126571 DOI: 10.1161/circulationaha.122.063167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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29
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Atrial Tissue Characterization Via Cardiac Magnetic Resonance in Acute Myocarditis and Takotsubo Syndrome is Needed. J Thorac Imaging 2023; 38:W43. [PMID: 36795982 DOI: 10.1097/rti.0000000000000700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
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Any Cardiac Influence of the Structural and Functional Brain Changes in Patients With Takotsubo Syndrome? JACC. HEART FAILURE 2023; 11:617. [PMID: 37137664 DOI: 10.1016/j.jchf.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 02/21/2023] [Indexed: 05/05/2023]
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31
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Further refining of the murine model of intraperitoneal injection of isoproterenol-induced takotsubo syndrome. Am J Physiol Heart Circ Physiol 2023; 324:H654. [PMID: 37014081 DOI: 10.1152/ajpheart.00100.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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32
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Women/Cancer/Myocardial Infarction Nonobstructive Coronary Arteries/Takotsubo Syndrome: Two Electrocardiogram-Based Tests With Potential Value. Am J Cardiol 2023; 196:107-108. [PMID: 37105839 DOI: 10.1016/j.amjcard.2023.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/29/2023]
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Correction: A proposal of a new index of coronary microvascular resistance based on the duration of the transient ECG repolarization changes during coronary angiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1207. [PMID: 37040063 DOI: 10.1007/s10554-023-02822-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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34
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Prevalence of obesity and diabetes in patients with takotsubo syndrome from the Tokyo Cardiovascular Care Unit Network Registry. J Cardiol 2023:S0914-5087(23)00064-3. [PMID: 37028506 DOI: 10.1016/j.jjcc.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/15/2023] [Accepted: 04/01/2023] [Indexed: 04/09/2023]
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Some inquiries about the currently launched BROKEN SWEDEHEART therapeutic trial for takotsubo syndrome. Am Heart J 2023; 258:190-191. [PMID: 36925272 DOI: 10.1016/j.ahj.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Antiplatelet therapy at discharge for takotsubo syndrome: could propensity matching and/or sensitivity analysis be of value? Rev Port Cardiol 2023:S0870-2551(23)00187-7. [PMID: 37019278 DOI: 10.1016/j.repc.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/23/2022] [Indexed: 04/05/2023] Open
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Atrial Fibrillation Ablation and Takotsubo Syndrome. JACC Clin Electrophysiol 2023; 9:422-423. [PMID: 36990599 DOI: 10.1016/j.jacep.2023.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 03/29/2023]
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Atherosclerotic Nonobstructive Coronary Artery Disease in Patients With Takotsubo Syndrome and Heart Failure: A Contributor or a Red Herring? CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 48:41. [PMID: 36344415 DOI: 10.1016/j.carrev.2022.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 10/28/2022] [Indexed: 11/15/2022]
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Ischemic stroke-related takotsubo syndrome and atrial fibrillation: Some answers to vexing questions. J Stroke Cerebrovasc Dis 2023; 32:106925. [PMID: 36508755 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022] Open
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40
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Right versus left breast radiation and coronary artery disease: is there a differential? Acta Cardiol 2023; 78:5-12. [PMID: 36378524 DOI: 10.1080/00015385.2022.2141431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is literature supporting the view that chest radiation (CR) for the management of primary or metastatic cancer of the mediastinum and chest, including breast cancer is associated with all types of heart disease, including coronary artery disease (CAD), manifesting during long-term follow-up. This review explores the literature about the association of CR for the management of cancer and CAD, particularly focussing on breast cancer, and further on the differential between CR for right versus left breast cancer. The balk of the literature suggests that there is higher incidence of CAD in patients undergoing left versus right-CR for breast cancer, and that cardiologists and oncologists need to become involved systematically in their assessment prior to CR and at subsequent follow-up.
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New research avenues for the prognostic value of the Tpeak-Tend interval in patients with different morphological variants of tako-tsubo syndrome. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2023; 76:490-491. [PMID: 36669733 DOI: 10.1016/j.rec.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 01/19/2023]
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Reversible
QRS
attenuation/fragmentation in patients with takotsubo syndrome. J Arrhythm 2023; 39:245. [PMID: 37021022 PMCID: PMC10068923 DOI: 10.1002/joa3.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/01/2023] [Accepted: 01/02/2023] [Indexed: 01/13/2023] Open
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A proposal of a new index of coronary microvascular resistance based on the duration of the transient ECG repolarization changes during coronary angiography. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2023; 39:1075-1077. [PMID: 36607470 DOI: 10.1007/s10554-022-02791-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023]
Abstract
Coronary microvascular dysfunction is present in the majority of patients with acute coronary syndromes, myocardial infarction with nonobstructive coronary arteries, and takotsubo syndrome. Assessment of the coronary microcirculation via a noninvasive index of coronary microvascular resistance (CMVR) based on coronary angiography is currently employed by many laboratories (AngioMVR). A proposal is presented herein of a new index of CMVR, based on the duration of the transient ECG repolarization changes during coronary angiography (ECGMVR), well known to occur in patients with and without coronary artery disease, and specific for the left and right coronary artery contrast injections, which have been widely documented, starting 60 years ago. It will be imperative for the index of ECGMVR to be correlated with the currently implemented AngioMVR and the TIMI frame count index, for the validation of the ECGMVR.
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Two Electrocardiographic Aberrations Important for All Caring for Patients to Know about. Cardiology 2022; 148:58-61. [PMID: 36404701 DOI: 10.1159/000528173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Two electrocardiographic (ECG) aberrations encountered daily in ECG interpretation/overreading, which appear to be either unknown or ignored, by all caring for patients, are described herein: the 1st is the transient increase in the amplitude of QRS complexes in the right precordial ECG leads, leading to the erroneous diagnosis of left ventricular hypertrophy, often encountered in patients with episodes of supraventricular tachycardia, rapid sinus tachycardia, and atrial fibrillation; the 2nd is the spurious ST-segment elevations in lateral and/or inferior ECG leads in patients with right bundle branch block, interpreted by the automated ECG diagnostic algorithms as due to "acute myocardial infarction," "ischemic injury," "pericarditis," and "early repolarization," in the absence of such pathologies or electrophysiological explanations.
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"Obesity paradox" and takotsubo syndrome. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2022; 15:200152. [PMID: 36573191 PMCID: PMC9789358 DOI: 10.1016/j.ijcrp.2022.200152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/07/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
Background An "obesity paradox" has been reported in patients with hypertension and heart failure, in which obese patients fare better than patients with normal-weight. The purpose of this study was to determine whether there is an "obesity paradox" in patients with takotsubo syndrome (TTS). Methods The prevalence of obesity in databases/registries of patients with TTS was compared to the prevalence of obesity in world general populations. Obese patients with TTS were explored regarding the stress triggers precipitating the illness, hospital outcome, and post-discharge readmission. Finally, the literature on the "obesity paradox" was explored to understand how it could be applied to TTS. Results A prevalence of obesity of ∼10-11% has been reported in large cohorts of patients with TTS, which represents 1/3 to ¼ of the prevalence reported in worldwide general populations, suggesting that, normal-weight than obese individuals, are more predisposed to develop TTS, with the latter nevertheless also suffering TTS, when triggered by enormous physical stresses. Obese patients with TTS are likely to have milder hospital outcomes, lower mortality, and lower rate of early readmission. A greater sympathetic nervous system (SNS) response in a number of hyperadrenergic states in normal-weight than obese patients, may explain findings in patients with TTS. Conclusions An "obesity paradox" has been identified in patients with TTS. Reporting on body mass index and other markers of obesity in patients with TTS, and implementing some recommendations on monitoring noninvasively the SNS in patients with TTS, may solidify that obesity has a preventive/ameliorating effect for TTS development and its clinical course.
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Letter by Madias and Madias Regarding Article, "Efficacy and Safety of Appropriate Shocks and Antitachycardia Pacing in Transvenous and Subcutaneous Implantable Defibrillators: Analysis of All Appropriate Therapy in the PRAETORIAN Trial". Circulation 2022; 146:e8-e9. [PMID: 35877833 DOI: 10.1161/circulationaha.122.059815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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47
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Beware of Making the Diagnosis of Hypertrophic Cardiomyopathy in Patients with Takotsubo Syndrome Based on Early Imaging. J Cardiovasc Echogr 2022; 32:185-186. [PMID: 36619777 PMCID: PMC9819607 DOI: 10.4103/jcecho.jcecho_16_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/09/2022] [Accepted: 07/12/2022] [Indexed: 01/10/2023] Open
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Inquiries/comments about a patient with adrenaline-triggered mid-ventricular Takotsubo syndrome. Ir J Med Sci 2022; 192:613-614. [PMID: 35644824 DOI: 10.1007/s11845-022-03035-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 10/18/2022]
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Correspondence on 'Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome' by Silverio et al. BRITISH HEART JOURNAL 2022; 108:1242. [PMID: 35606112 DOI: 10.1136/heartjnl-2022-321203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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50
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Pathophysiology of Takotsubo Syndrome Explored in the Cardiac Electrophysiology Laboratory. JACC Clin Electrophysiol 2022; 8:684-685. [PMID: 35589184 DOI: 10.1016/j.jacep.2022.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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