Assuntos
Antagonistas Adrenérgicos , Sistema Nervoso Autônomo , Catecolaminas/metabolismo , Cardiomiopatia de Takotsubo/tratamento farmacológico , Antagonistas Adrenérgicos/farmacologia , Antagonistas Adrenérgicos/uso terapêutico , Sistema Nervoso Autônomo/efeitos dos fármacos , Sistema Nervoso Autônomo/metabolismo , Humanos , Conduta do Tratamento Medicamentoso , Cardiomiopatia de Takotsubo/metabolismo , Cardiomiopatia de Takotsubo/fisiopatologiaRESUMO
BACKGROUND: Tako-tsubo cardiomyopathy has been gradually recognized worldwide. However, medications for the prevention remain not to be investigated in part because the precise mechanism is unclear. We sought to examine medications before the onset of tako-tsubo cardiomyopathy, and to prove the limitation of these medications for the prevention. METHODS AND RESULTS: This study consisted of 21 patients with tako-tsubo cardiomyopathy who received one or more medications for hypertension or suspected angina pectoris. Each patient was assessed with history, medications, coronary angiography and left ventriculography. All patients but 1 were female, and age ranged 41 to 87 years (73+/-11 years). Twelve patients received calcium channel blockers, 7 patients received nitrates, and one patient received beta blocker. Three patients received angiotensin coverting enzyme inhibitors, and 4 patients received angiotensin II receptor blockers. One patient died of serious pneumonia, but there was no patient who died of tako-tsubo cardiomyopathy itself. During the 3 year follow-up, one patient receiving angiotensin receptor blocker had the recurrence of tako-tsubo cardiomyopathy due to recurrent epileptic seizure. CONCLUSIONS: Tako-tsubo cardiomyopathy can occur despite treatment with calcium channel blockers, nitrates or beta-blockers, suggesting limitation of these medications to prevent tako-tsubo cardiomyopathy.
Assuntos
Cardiomiopatia de Takotsubo/tratamento farmacológico , Cardiomiopatia de Takotsubo/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angina Pectoris/complicações , Angina Pectoris/tratamento farmacológico , Angina Pectoris/prevenção & controle , Fármacos Cardiovasculares/uso terapêutico , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipertensão/prevenção & controle , Masculino , Pessoa de Meia-Idade , Preparações Farmacêuticas , Cardiomiopatia de Takotsubo/prevenção & controleRESUMO
We evaluated left ventricular (LV) function by three-dimensional echocardiography (3DE) in a patient with takotsubo cardiomyopathy (TC). An 82-year-old man was admitted to our hospital with a suspicion of acute myocardial infarction but was diagnosed as TC by coronary angiography and left ventriculography (LVG). Three-dimensional echocardiography showed circular asynergy from the midventricle to the apex associated with hyperkinesis of the base and volumetric data very close to those obtained by LVG. Thus, 3DE is a useful tool in evaluating regional wall motion abnormalities and LV volume in patients with TC.