Эндотелийзависимая вазодилатация плечевой артерии у пациентов с кардиомиопатией такотсубо
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Methods. We compared the results of FMD tests of 5 women with TTC with the results of 18 women with ST elevation acute myocardial infarction (STEMI) and of 26 healthy female volunteers. FMD tests in all patients were performed within 24 hours of admission and again at 1-3 weeks as a follow-up.
Results. The FMD levels were lower at the acute phase in patients with TTC than in patients with STEMI and in healthy volunteers (p < 0. 01). After 1-3 weeks, the FMD test results of patients with TTC had greatly increased, and no significant differences were found between these results and the results from patients with STEMI (p>0.05). There were no significant differences in the FMD test results between the group of patients with TTC and the group of healthy volunteers (p>0.05).
Conclusions. There is a pronounced and reversible endothelial dysfunction in patients with TTC, which can impair myocardial perfusion.
Akashi Y. J., Musha H., Kida K. et al. Reversible ventricular dysfunction takotsubo cardiomyopathy // Eur. J. Heart Fail. 2005. Vol. 7. P. 1171-1176.
Celermajer D. S., Sorensen K. E., Gooch V. M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis // Lancet. 1992. Vol. 340. P. 1111-1115.
Elesber A., Lerman A., Bybee K. A. et al. Myocardial perfusion in apical ballooning syndrome correlate of myocardial injury // Am. Heart J. 2006. Vol. 152, № 3. P. 469-413.
Fazio G., Sarullo F. M., Novo G. et al. Tako-tsubo cardiomyopathy and microcirculation // J. Clin. Monit. Comput. 2010. Vol. 24, № 2. P. 101-105.
Feola M., Chauvie S., Rosso G. L. et al. Reversible impairment of coronary flow reserve in takotsubo cardiomyopathy: a myocardial PET study // J. Nucl. Cardiol. 2008. Vol. 15. P. 811-817.
Gianni M., Dentali F., Grandi A. M. et al. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review // Eur. Heart J. 2006. Vol. 27. P. 1523-1529.
Izumi Y., Okatani H., Shiota M. et al. Effects of metoprolol on epinephrine-induced takotsubo-like left ventricular dysfunction in non-human primates // Hypertens Res. 2009. Vol. 32. P. 339-346.
Kawai S., Kitabatake A., Tomoike H. Guidelines for diagnosis of takotsubo (ampulla) cardiomyopathy // Circ. J. 2007. Vol. 71. P. 990-992.
Kume T., Akasaka T., Kawamoto T. et al. Assessment of coronary microcirculation in patients with takotsubo-like left ventricular dysfunction // Circ. J. 2005. Vol. 69, № 8. P. 934-939.
Kume T., Kawamoto T., Okura H. et al. Local release of catecholamines from the hearts of patients with tako-tsubo-like left ventricular dysfunction // Circ. J. 2008. Vol. 72. P. 106-108.
Martin E. A., Prasad A., Rihal C. S. et al. Endothelial function and vascular response to mental stress are impaired in patients with apical ballooning syndrome // J. Am. Coll. Cardiol. 2010. Vol. 56, № 22. P. 1840-1846.
Meimoun P., Malaquin D., Benali T. et al. Assessment of coronary flow reserve by transthoracic Doppler echocardiography in left apical ballooning syndrome // Eur. J. Echocardiogr. 2008. Vol. 9. P. 78-79.
Meimoun P., Malaquin D., Sayah S. et al. The coronary flow reserve is transiently impaired in tako-tsubo cardiomyopathy: a prospective study using serial Doppler transthoracic echocardiography // J. Am. Soc. Echocardiogr. 2008. Vol. 21, № 1. P. 72-77.
Nishikawa S., Ito K., Adachi Y. et al. Ampulla ('takotsubo') cardiomyopathy of both ventricles: eval uation of microcirculation disturbance using 99mTc-tetrofosmin myocardial single photon emission computed tomography and doppler guide wire // Circ. J. 2004. Vol. 68. P. 1076-1080.
Sganzerla P., Alioto G., Funaro A. et al. Transthoracic Doppler ultrasound coronary flow reserve evaluation: preliminary insights into pathophysiology of Takotsubo cardiomyopathy // J. Cardiovasc. Med. 2008. Vol. 9. P. 1229-1234
Skantze H. B., Kaplan J., Pettersson K. et al. Psychosocial stress causes endothelial injury in cynomolgus monkeys via beta1-adrenoceptor activation // Atherosclerosis. 1998. Vol. 136. P. 153-161.
Thygesen K., Alpert J. S., White H. D. et al. Universal definition of myocardial infarction // Circulation. 2007. Vol. 116. P. 2634-2653.
Uchida Y., Egami H., Sakurai T. et al. Possible participation of endothelial cell apoptosis of coronary microvessels in the genesis of Takotsubo cardiomyopathy // Clin. Cardiol. 2010. Vol. 33, № 6. P. 371-377.
Vasilieva E., Vorobyeva I., Lebedeva A. et al. Brachial artery flow-mediated dilation in patients with Tako-tsubo cardiomyopathy // Am. J. Med. 2011. Vol. 124. P. 1176-1179.
Vasilieva E., Urazovskaya I., Skrypnik D., Shpektor A. Total occlusion of the infarct-related coronary artery correlates with brachial artery flow-mediated dilation in patients with ST-elevation myocardial infarction // Acute Card. Care. 2009. Vol. 11, № 3. P. 155-159.
Abstract
Background. Tako-Tsubo cardiomyopathy (TTC) is associated with transient myocardial contractile dysfunction. The purpose of this study was to investigate brachial artery flow-mediated dilation (FMD) in patients with TTC.Methods. We compared the results of FMD tests of 5 women with TTC with the results of 18 women with ST elevation acute myocardial infarction (STEMI) and of 26 healthy female volunteers. FMD tests in all patients were performed within 24 hours of admission and again at 1-3 weeks as a follow-up.
Results. The FMD levels were lower at the acute phase in patients with TTC than in patients with STEMI and in healthy volunteers (p < 0. 01). After 1-3 weeks, the FMD test results of patients with TTC had greatly increased, and no significant differences were found between these results and the results from patients with STEMI (p>0.05). There were no significant differences in the FMD test results between the group of patients with TTC and the group of healthy volunteers (p>0.05).
Conclusions. There is a pronounced and reversible endothelial dysfunction in patients with TTC, which can impair myocardial perfusion.
References
Abdelmoneim S. S., Mankad S. V., Bernier M. et al. Microvascular function in Takotsubo cardiomyopathy with contrast echocardiography: prospective evaluation and review of literature // J. Am. Soc. Echocardiogr. 2009. Vol. 22. P. 1249-1255.Akashi Y. J., Musha H., Kida K. et al. Reversible ventricular dysfunction takotsubo cardiomyopathy // Eur. J. Heart Fail. 2005. Vol. 7. P. 1171-1176.
Celermajer D. S., Sorensen K. E., Gooch V. M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis // Lancet. 1992. Vol. 340. P. 1111-1115.
Elesber A., Lerman A., Bybee K. A. et al. Myocardial perfusion in apical ballooning syndrome correlate of myocardial injury // Am. Heart J. 2006. Vol. 152, № 3. P. 469-413.
Fazio G., Sarullo F. M., Novo G. et al. Tako-tsubo cardiomyopathy and microcirculation // J. Clin. Monit. Comput. 2010. Vol. 24, № 2. P. 101-105.
Feola M., Chauvie S., Rosso G. L. et al. Reversible impairment of coronary flow reserve in takotsubo cardiomyopathy: a myocardial PET study // J. Nucl. Cardiol. 2008. Vol. 15. P. 811-817.
Gianni M., Dentali F., Grandi A. M. et al. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review // Eur. Heart J. 2006. Vol. 27. P. 1523-1529.
Izumi Y., Okatani H., Shiota M. et al. Effects of metoprolol on epinephrine-induced takotsubo-like left ventricular dysfunction in non-human primates // Hypertens Res. 2009. Vol. 32. P. 339-346.
Kawai S., Kitabatake A., Tomoike H. Guidelines for diagnosis of takotsubo (ampulla) cardiomyopathy // Circ. J. 2007. Vol. 71. P. 990-992.
Kume T., Akasaka T., Kawamoto T. et al. Assessment of coronary microcirculation in patients with takotsubo-like left ventricular dysfunction // Circ. J. 2005. Vol. 69, № 8. P. 934-939.
Kume T., Kawamoto T., Okura H. et al. Local release of catecholamines from the hearts of patients with tako-tsubo-like left ventricular dysfunction // Circ. J. 2008. Vol. 72. P. 106-108.
Martin E. A., Prasad A., Rihal C. S. et al. Endothelial function and vascular response to mental stress are impaired in patients with apical ballooning syndrome // J. Am. Coll. Cardiol. 2010. Vol. 56, № 22. P. 1840-1846.
Meimoun P., Malaquin D., Benali T. et al. Assessment of coronary flow reserve by transthoracic Doppler echocardiography in left apical ballooning syndrome // Eur. J. Echocardiogr. 2008. Vol. 9. P. 78-79.
Meimoun P., Malaquin D., Sayah S. et al. The coronary flow reserve is transiently impaired in tako-tsubo cardiomyopathy: a prospective study using serial Doppler transthoracic echocardiography // J. Am. Soc. Echocardiogr. 2008. Vol. 21, № 1. P. 72-77.
Nishikawa S., Ito K., Adachi Y. et al. Ampulla ('takotsubo') cardiomyopathy of both ventricles: eval uation of microcirculation disturbance using 99mTc-tetrofosmin myocardial single photon emission computed tomography and doppler guide wire // Circ. J. 2004. Vol. 68. P. 1076-1080.
Sganzerla P., Alioto G., Funaro A. et al. Transthoracic Doppler ultrasound coronary flow reserve evaluation: preliminary insights into pathophysiology of Takotsubo cardiomyopathy // J. Cardiovasc. Med. 2008. Vol. 9. P. 1229-1234
Skantze H. B., Kaplan J., Pettersson K. et al. Psychosocial stress causes endothelial injury in cynomolgus monkeys via beta1-adrenoceptor activation // Atherosclerosis. 1998. Vol. 136. P. 153-161.
Thygesen K., Alpert J. S., White H. D. et al. Universal definition of myocardial infarction // Circulation. 2007. Vol. 116. P. 2634-2653.
Uchida Y., Egami H., Sakurai T. et al. Possible participation of endothelial cell apoptosis of coronary microvessels in the genesis of Takotsubo cardiomyopathy // Clin. Cardiol. 2010. Vol. 33, № 6. P. 371-377.
Vasilieva E., Vorobyeva I., Lebedeva A. et al. Brachial artery flow-mediated dilation in patients with Tako-tsubo cardiomyopathy // Am. J. Med. 2011. Vol. 124. P. 1176-1179.
Vasilieva E., Urazovskaya I., Skrypnik D., Shpektor A. Total occlusion of the infarct-related coronary artery correlates with brachial artery flow-mediated dilation in patients with ST-elevation myocardial infarction // Acute Card. Care. 2009. Vol. 11, № 3. P. 155-159.
