Takotsubo (Stress) Cardiomyopathy Can KillTakotsubo(应激性)心肌病可致死

A retrospective study found that takotsubo (stress) cardiomyopathy represents an acute heart failure syndrome with substantial morbidity and mortality. 1750 patients with takotsubo cardiomyopathy were compared with age- and sex-matched patients who had an acute coronary syndrome. Among patients with takotsubo cardiomyopathy, 89.8% were women (mean age, 66.8 years). Emotional triggers were not as common as physical triggers (27.7% vs. 36.0%), and 28.5% of patients had no evident trigger. Compared with an acute coronary syndrome, rates of neurologic or psychiatric disorders were higher (55.8% vs. 25.7%) and the mean left ventricular ejection fraction was markedly lower (40.7±11.2% vs. 51.5±12.3%). Rates of severe in-hospital complications including shock and death were similar in the two groups. Physical triggers, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission were independent predictors for in-hospital complications. During long-term follow-up, the rate of major adverse cardiac and cerebrovascular events was 9.9% per patient-year, and the rate of death was 5.6% per patient-year. The condition, often referred as “broken heart syndrome”, was first described in Japan in 1990 and believed to be a benign disorder of older women triggered by highly stressful events. “Takotsubo” is a Japanese word for an octopus trap that resembles the heart’s shape during abnormal contracture. Source: http://www.nejm.org/

一项回顾性研究发现,Takotsubo(应激性)心肌病是一种发病率和死亡率相当高的急性心衰综合征。 该研究对1750例Takotsubo心肌病与年龄和性别匹配的急性冠脉综合征患者进行了比较。Takotsubo心肌病患者89.8%为女性(平均年龄66.8岁)。情感诱因并不比体力诱因更常见(27.7%对36.0%),且28.5%的病人无明显诱因。与急性冠脉综合征相比,神经或精神疾病率较高(55.8%对25.7%)而平均左心室射血分数显着降低(40.7±11.2%和51.5±12.3%)。住院期间的严重并发症,包括休克和死亡率则两组相似。有体力诱因,急性神经或精神疾病,高肌钙蛋白水平,并在入院时射血分数低均为住院期间并发症的独立预测因素。长期随访期间,主要不良心脑血管事件发生率为每病人年9.9%,死亡率为每病人年5.6%。该病通常被称为“伤心综合症”,最早在1990年描述于日本,相信是由高度紧张的事件触发的老年妇女的良性疾病。 “Takotsubo”是一个日本词,一种类似于心脏异常挛缩时形状的章鱼陷阱。来源:http://www.nejm.org/

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