Takotsubo病理生理学和并发症:我们知道的和不知道的。

IF 4.5 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Heart Failure Reviews Pub Date : 2024-03-01 Epub Date: 2023-12-27 DOI:10.1007/s10741-023-10381-8
Mehdi Shadmand, Jacob Lautze, Ali Mehdirad Md
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引用次数: 0

摘要

Takotsubo 心肌病或应激性心肌病(SCM)于 1990 年首次被描述,最初人们认为它只与短期并发症和死亡率有关,长期预后与健康人群相当。然而,最近的调查证明并非如此,调查显示,SCM 患者的长期发病率和死亡率可能与 STEMI(ST 段抬高型心肌梗死)患者相当。许多情绪或身体压力因素都可能诱发急性心肌梗死,神经激素和炎症机制的相互作用已被描述为这种疾病的病理生理学基础。此外,鉴于绝经后妇女的单核细胞增多症发病率明显较高,雌激素水平被认为在该病的发病机制中起着一定的作用。此外,不同诱因导致的预后差异也令人难以捉摸。目前,关于如何对这些患者进行长期管理,以降低发病率、死亡率并提高生活质量(如是否需要长期抗凝),许多问题仍未得到解答。在本文中,我们将回顾最近发表的有关单核细胞增多症的病因、病理生理学、诊断标准、预后、短期并发症以及更详细的长期并发症的研究结果。最后,我们将讨论未来需要开展哪些研究来进一步了解这种疾病,以改善长期预后,尽管目前仍缺乏长期管理方面的数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Takotsubo pathophysiology and complications: what we know and what we do not know.

Takotsubo pathophysiology and complications: what we know and what we do not know.

Takotsubo cardiomyopathy or stress cardiomyopathy (SCM), was first described in 1990 and initially, it was thought to be only associated with short-term complications and mortality with a benign long-term prognosis comparable to a healthy population. However recent investigations have proven otherwise and have shown SCM patients might have comparable long-term morbidity and mortality to ST-elevation myocardial infarction (STEMI) patients. Many emotional, or physical stressors can trigger SCM, and have been able to describe an interplay of neurohormonal and inflammatory mechanisms as the pathophysiology of this disease. Additionally, given the significantly higher prevalence of SCM in post-menopausal women, estrogen levels have been thought to play a role in the pathogenesis of this disease. Furthermore, there is an elusive disparity in prognosis depending upon different triggers. Currently, many questions remain unanswered regarding the long-term management of these patients to reduce morbidity, mortality, and improve quality of life, such as the need for long-term anticoagulation. In this paper, we review the findings of most recent published investigations regarding etiologies, pathophysiology, diagnostic criteria, prognosis, short-term and in more detail, long-term complications of SCM. Finally, we will discuss what future research is needed to learn more about this disease to improve the long-term prognosis, even though as of now, data for long-term management is still lacking.

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来源期刊
Heart Failure Reviews
Heart Failure Reviews 医学-心血管系统
CiteScore
10.40
自引率
2.20%
发文量
90
审稿时长
6-12 weeks
期刊介绍: Heart Failure Reviews is an international journal which develops links between basic scientists and clinical investigators, creating a unique, interdisciplinary dialogue focused on heart failure, its pathogenesis and treatment. The journal accordingly publishes papers in both basic and clinical research fields. Topics covered include clinical and surgical approaches to therapy, basic pharmacology, biochemistry, molecular biology, pathology, and electrophysiology. The reviews are comprehensive, expanding the reader''s knowledge base and awareness of current research and new findings in this rapidly growing field of cardiovascular medicine. All reviews are thoroughly peer-reviewed before publication.
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