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Takotsubo syndrome and left ventricular non-compaction cardiomyopathy: Casualty or causality?

      Highlights

      • Takotsubo syndrome (TS) is an acute form of neurocardiogenic stunning.
      • Altered autonomic-limbic processing supports brain-heart axis in TS.
      • Sympathetic activation with catecholamine release, causes myocardial toxicity and/or coronary microvascular dysfunction.
      • Left ventricular non-compaction cardiomyopathy (LVNC) is a rare disease characterized by a subverted myocardial architecture.
      • LVNC may predispose to TS because associated with coronary microvascular and autonomic dysfunction.

      Abstract

      Takotsubo syndrome (TS) is a condition of transient regional ventricular systolic dysfunction, usually presenting with acute chest pain and/or dyspnea, that is increasingly recognized especially in post-menopausal women following a psychological or physical stress. Initially considered as a benign condition with an isolated and self-limiting episode, it is now recognized that it is associated with a significant risk of in-hospital mortality and of recurrence. We herein describe a case of a 61-year-old female with left ventricular non-compaction cardiomyopathy (LVNC) who experienced a recurrence of TS, highlighting the potential pathophysiological role for LVNC in predisposing this syndrome and its recurrence. Moreover, we underscored possible therapeutic implications deriving from this case.

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      References

        • De Rosa G.
        • Pardeo M.
        • Di Rocco C.
        • et al.
        Neurogenic stunned myocardium presenting as left ventricular hypertrabeculation in childhood: a variant of Takotsubo cardiomyopathy?.
        Pediatr. Crit. Care Med. 2011; 12: e420-e423https://doi.org/10.1097/PCC.0b013e3182192944
        • Diwadkar S.
        • Nallamshetty L.
        • Rojas C.
        • Athienitis A.
        • Declue C.
        • Cox C.
        • Patel A.
        • Chae S.H.
        Echocardiography fails to detect left ventricular noncompaction in a cohort of patients with noncompaction on cardiac magnetic resonance imaging.
        Clin. Cardiol. 2017; 40 (Jun): 364-369https://doi.org/10.1002/clc.22669
        • Finsterer J.
        • Stöllberger C.
        • Hornykewycz A.
        • Gencik M.
        Noncompaction predisposing for recurrent Takotsubo syndrome in myotonic dystrophy 1.
        Int. J. Cardiol. 2013; 168 (Epub 2013 Jul 25): e38-e39https://doi.org/10.1016/j.ijcard.2013.06.125
        • Finsterer J.
        • Stöllberger C.
        • Towbin J.A.
        Left ventricular noncompaction cardiomyopathy: cardiac, neuromuscular, and genetic factors.
        Nat. Rev. Cardiol. 2017; 14: 224-237https://doi.org/10.1038/nrcardio.2016.207
        • Galiuto L.
        • De Caterina A.R.
        • Porfidia A.
        • Paraggio L.
        • Barchetta S.
        • Locorotondo G.
        • Rebuzzi A.G.
        • Crea F.
        Reversible coronary microvascular dysfunction: a common pathogenetic mechanism in Apical Ballooning or Tako-Tsubo Syndrome.
        Eur. Heart J. 2010; 31 (Epub 2010 Mar 9): 1319-1327https://doi.org/10.1093/eurheartj/ehq039
        • Jenni R.
        • Wyss C.A.
        • Oechslin E.N.
        • Kaufmann P.A.
        Isolated ventricular noncompaction is associated with coronary microcirculatory dysfunction.
        J. Am. Coll. Cardiol. 2002; 39: 450-454
        • Karamitsos T.D.
        • Bull S.
        • Spyrou N.
        • Neubauer S.
        • Selvanayagam J.B.
        Tako-tsubo cardiomyopathy presenting with features of left ventricular non-compaction.
        Int. J. Cardiol. 2008; 128: e34-e36
        • Kawasaki T.
        • Azuma A.
        • Taniguchi T.
        • Asada S.
        • Kamitani T.
        • Kawasaki S.
        • Matsubara H.
        • Sugihara H.
        Heart rate variability in adult patients with isolated left ventricular noncompaction.
        Int. J. Cardiol. 2005; 99: 147-150
        • Medina de Chazal H.
        • Del Buono M.G.
        • Keyser-Marcus L.
        • et al.
        Stress cardiomyopathy diagnosis and treatment: JACC state-of-the-art review.
        J. Am. Coll. Cardiol. 2018; 72 (Review): 1955-1971https://doi.org/10.1016/j.jacc.2018.07.072
        • Pelliccia F.
        • Kaski J.C.
        • Crea F.
        • Camici P.G.
        Pathophysiology of Takotsubo syndrome.
        Circulation. 2017; 135: 2426-2441
        • Petersen S.E.
        • Selvanayagam J.B.
        • Wiesmann F.
        • Robson M.D.
        • Francis J.M.
        • Anderson R.H.
        • Watkins H.
        • Neubauer S.
        Left ventricular non-compaction: insights from cardiovascular magnetic resonance imaging.
        J. Am. Coll. Cardiol. 2005; 46: 101-105
        • Singh K.
        • Carson K.
        • Usmani Z.
        • Sawhney G.
        • Shah R.
        • Horowitz J.
        Systematic review and meta-analysis of incidence and correlates of recurrence of takotsubo cardiomyopathy.
        Int. J. Cardiol. 2014; 174: 696-701
        • Sonnino C.
        • Van Tassell B.W.
        • Toldo S.
        • Del Buono M.G.
        • Moeller F.G.
        • Abbate A.
        Lack of soluble circulating cardiodepressant factors in takotsubo cardiomyopathy.
        Auton. Neurosci. 2017; 208 (Epub 2017 Nov 2): 170-172https://doi.org/10.1016/j.autneu.2017.10.010
        • Templin C.
        • Ghadri J.R.
        • Diekmann J.
        • Napp L.C.
        • Bataiosu D.R.
        • Jaguszewski M.
        • Cammann V.L.
        • Sarcon A.
        • Geyer V.
        • Neumann C.A.
        • Seifert B.
        • Hellermann J.
        • Schwyzer M.
        • Eisenhardt K.
        • Jenewein J.
        • Franke J.
        • Katus H.A.
        • Burgdorf C.
        • Schunkert H.
        • Moeller C.
        • Thiele H.
        • Bauersachs J.
        • Tschöpe C.
        • Schultheiss H.P.
        • Laney C.A.
        • Rajan L.
        • Michels G.
        • Pfister R.
        • Ukena C.
        • Böhm M.
        • Erbel R.
        • Cuneo A.
        • Kuck K.H.
        • Jacobshagen C.
        • Hasenfuss G.
        • Karakas M.
        • Koenig W.
        • Rottbauer W.
        • Said S.M.
        • Braun-Dullaeus R.C.
        • Cuculi F.
        • Banning A.
        • Fischer T.A.
        • Vasankari T.
        • Airaksinen K.E.
        • Fijalkowski M.
        • Rynkiewicz A.
        • Pawlak M.
        • Opolski G.
        • Dworakowski R.
        • MacCarthy P.
        • Kaiser C.
        • Osswald S.
        • Galiuto L.
        • Crea F.
        • Dichtl W.
        • Franz W.M.
        • Empen K.
        • Felix S.B.
        • Delmas C.
        • Lairez O.
        • Erne P.
        • Bax J.J.
        • Ford I.
        • Ruschitzka F.
        • Prasad A.
        • Lüscher T.F.
        Clinical features and outcomes of Takotsubo (stress) cardiomyopathy.
        N. Engl. J. Med. 2015; 373: 929-938https://doi.org/10.1056/NEJMoa1406761