Кардиомиопатия такотсубо. Часть 2

Авторы: А. М. Лебедева *, Е. Ю. Васильева, А. В. Шпектор

Организация:
Кафедра кардиологии ФПДО ГБОУ ВПО «Московский государственный медико-стоматологический университет им. А. И. Евдокимова» Министерства здравоохранения РФ

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Тип статьи: Клиническая лекция

Ключевые слова: кардиомиопатия такотсубо, острый инфаркт миокарда с подъемом ST, резерв коронарного кровотока, кортикотропин-рилизинг-гормон, дисфункция эндотелия, эндотелийзависимая вазодилатация плечевой артерии

Полнотекстовая версия:  

 

Аннотация

Кардиомиопатия такотсубо (КМПТ) - редкий вид кардиомиопатии, при котором возникают обратимые нарушения сократимости миокарда. В первой лекции нами была рассмотрена эпидемиология и ранние гипотезы возникновения синдрома. В данной лекции описаны наиболее распространенные теории патогенеза кардиомиопатии такотсубо. Среди них теория о нарушении резерва коронарного кровотока в острой фазе КМПТ. Интересна также роль эндотелиальной дисфункции (имевшей место в нашем исследовании) в патогенезе КМПТ. Подробно рассмотрены возможные причины, по которым кардиомиопатия такотсубо возникает преимущественно у женщин.

Литература

1. Ющук Е.Н., Васюк Ю.А., Хадзегова А.Б. и др. Эндотелиальная дисфункция при заболеваниях сердечно-сосудистой системы и методы ее кор- рекции // Клин. фармакол. и терапия. 2005. Vol. 14. P. 85–88.

2. 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.

3. Abe Y., Kondo M., Matsuoka R. et al. Assessment of clinical features in transient left ventricular apical ballooning // J. Am. Coll. Cardiol. 2003. Vol. 41. P. 737–742.

4. Afonso L., Bachour K., Awad K. et al. Takotsubo cardiomyopathy: Pathogenetic insights and myocardial perfusion kinetics using myocardial contrast echocardiography // Eur. J. Echocardiogr. 2008. Vol. 9. P. 849–854.

5. Azzarelli S., Giordano G., Galassi A.R. et al. Transient impairment of myocardial perfusion in a patient with apical ballooning syndrome // Int. J. Cardiol. 2007. Vol. 118. P. e63–65.

6. Behrendt D., Ganz P. Endothelial function: From vascular biology to clinical application // Am. J. Cardiol. 2002. Vol. 90.

7. Broadley A.J., Korszun A., Abdelaal E. et al. Inhibition of cortisol production with metyrapone prevents mental stress-induced endothelial dysfunction and baroreflex impairment // J. Am. Coll. Cardiol. 2005. Vol. 46. P. 344–350.

8. Bupha-Intr T., Wattanapermpool J. Regulatory role of ovarian sex hormones in calcium uptake activity of cardiac sarcoplasmic reticulum // Am. J. Physiol. Heart Circ. Physiol. 2006. Vol. 291. P. H1101–1108.

9. Bybee K.A., Kara T., Prasad A. et al. Systematic review: Transient left ventricular apical ballooning: A syndrome that mimics ST-segment elevation myocardial infarction // Ann. Intern. Med. 2004. Vol. 141. P. 858–865.

10. Bybee K.A., Prasad A., Barsness G.W. et al. Clinical characteristics and thrombolysis in myocardial infarction frame counts in women with transient left ventricular apical ballooning syndrome // Am. J. Cardiol. 2004. Vol. 94. P. 343–346.

11. Citro R., Galderisi M., Maione A. et al. Sequential transthoracic ultrasound assessment of coronary flow reserve in a patient with Tako-tsubo syndrome // J. Am. Soc. Echocardiogr. 2006. Vol. 19. P. 1402, e1405–1408.

12. Cuisset T., Quilici J., Pankert M. et al. Usefulness of index of microcirculatory resistance to detect microvascular dysfunction as a potential mechanism of stress-induced cardiomyopathy (tako-tsubo syndrome) // Int. J. Cardiol. 2011. Vol. 153. P. E51–E53.

13. Curtis A.L., Bethea T., Valentino R.J. Sexually dimorphic responses of the brain norepinephrine system to stress and corticotropin-releasing factor // Neuropsychopharmacology. 2006. Vol. 31. P. 544–554.

14. Desbonnet L., Garrett L., Daly E. et al. Sexually dimorphic effects of maternal separation stress on corticotrophin-releasing factor and vasopressin systems in the adult rat brain // Int. J. Dev. Neurosci. 2008. Vol. 26. P. 259–268.

15. 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. P. 469, e469–413.

16. Fazio G., Sarullo F.M., Novo G. et al. Tako-tsubo cardiomyopathy and microcirculation // J. Clin. Monit. Comput. 2010. Vol. 24. P. 101–105.

17. 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.

18. Gallucci W.T., Baum A., Laue L. et al. Sex differences in sensitivity of the hypothalamic-pituitaryadrenal axis // Health Psychol. 1993. Vol. 12. P. 420–425.

19. Ghiadoni L., Donald A.E., Cropley M. et al. Mental stress induces transient endothelial dysfunction in humans // Circulation. 2000. Vol. 102. P. 2473–2478.

20. 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.

21. Gornikiewicz A., Sautner T., Brostjan C. et al. Catecholamines up-regulate lipopolysaccharideinduced IL-6 production in human microvascular endothelial cells // FASEB J. 2000. Vol. 14. P. 1093–1100.

22. Grohe C., Kahlert S., Lobbert K. et al. Cardiac myocytes and fibroblasts contain functional estrogen receptors // FEBS Lett. 1997. Vol. 416. P. 107–112.

23. Handa R.J., Weiser M.J., Zuloaga D.G. A role for the androgen metabolite, 5 alpha-androstane-3 beta,17 beta-diol, in modulating oestrogen receptor beta-mediated regulation of hormonal stress reactivity // J. Neuroendocrinol. 2009. Vol. 21. P. 351–358.

24. Higashi Y., Sasaki S., Nakagawa K. et al. Excess norepinephrine impairs both endothelium-dependent and -independent vasodilation in patients with pheochromocytoma // Hypertension. 2002. Vol. 39. P. 513–518.

25. Hijmering M.L., Stroes E.S., Olijhoek J. et al. Sympathetic activation markedly reduces endothelium- dependent, flow-mediated vasodilation // J. Am. Coll. Cardiol. 2002. Vol. 39. P. 683–688.

26. Hinojosa-Laborde C., Chapa I., Lange D. et al. Gender differences in sympathetic nervous system regulation // Clin. Exp. Pharmacol. Physiol. 1999. Vol. 26. P. 122–126.

27. Hirata K., Shimada K., Watanabe H. et al. Modulation of coronary flow velocity reserve by gender, menstrual cycle and hormone replacement therapy // J. Am. Coll. Cardiol. 2001. Vol. 38. P. 1879–1884.

28. Ito K., Sugihara H., Kinoshita N. et al. Assessment of Takotsubo cardiomyopathy (transient left ventricular apical ballooning) using 99mTc-tetrofosmin, 123I-BMIPP, 123I-MIBG and 99mTc-PYP myocardial SPECT // Ann. Nucl. Med. 2005. Vol. 19. P. 435–445.

29. 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.

30. Krishnan U., Zacharzewski A., Schmitt M. Nonapical tako-tsubo cardiomyopathy associated with coronary slow flow: A case report and review of the literature // Clin. Cardiol. 2009. Vol. 32. P. E63–66.

31. 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. P. 934–939.

32. Luscher T., Barton M. Biology of the endothelium // Clin. Cardiol. 1997. Vol. 20 P. 3–10.

33. 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. P. 1840–1846.

34. Meimoun P., Malaquin D., Sayah S. et al. The coronary flow reserve is transiently impaired in takotsubo cardiomyopathy: A prospective study using serial Doppler transthoracic echocardiography // J. Am. Soc. Echocardiogr. 2008. Vol. 21. P. 72–77.

35. Nickel T., Deutschmann A., Hanssen H. et al. Modification of endothelial biology by acute and chronic stress hormones // Microvasc. Res. 2009. Vol. 78. P. 364–369.

36. Nishikawa S., Ito K., Adachi Y. et al. Ampulla ('takotsubo') cardiomyopathy of both ventricles: Evaluation of microcirculation disturbance using 99mTc-tetrofosmin myocardial single photon emission computed tomography and Doppler guide wire // Circ. J. 2004. Vol. 68. P. 1076–1080.

37. Peix A., Gonzalez A., Garcia E.J. et al. Left ventricular dysfunction secondary to ischemia in women with angina and normal coronary angiograms // J. Womens. Health (Larchmt). 2009. Vol. 18. P. 155–161.

38. Rigo F., Sicari R., Citro R. et al. Diffuse, marked, reversible impairment in coronary microcirculation in stress cardiomyopathy: A Doppler transthoracic echo study // Ann. Med. 2009. Vol. 41. P. 462–470.

39. Romeo F., Li D., Shi M. et al. Carvedilol prevents epinephrine-induced apoptosis in human coronary artery endothelial cells: Modulation of Fas/Fas ligand and caspase-3 pathway // Cardiovasc. Res. 2000. Vol. 45. P. 788–794.

40. Sadamatsu K., Tashiro H., Maehira N. et al. Coronary microvascular abnormality in the reversible systolic dysfunction observed after noncardiac disease // Jpn. Circ. J. 2000. Vol. 64. P. 789–792.

41. Sader M.A., Celermajer D.S. Endothelial function, vascular reactivity and gender differences in the cardiovascular system // Cardiovasc. Res. 2002. Vol. 53. P. 597–604.

42. Senovilla L., Nunez L., Villalobos C. et al. Rapid changes in anterior pituitary cell phenotypes in male and female mice after acute cold stress // Endocrinology. 2008. Vol. 149. P. 2159–2167.

43. 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. (Hagerstown). 2008. Vol. 9. P. 1229–1234.

44. 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.

45. Spieker L.E., Hurlimann D., Ruschitzka F. et al. Mental stress induces prolonged endothelial dysfunction via endothelin-A receptors // Circulation. 2002. Vol. 105. P. 2817–2820.

46. Thanky N.R., Son J.H., Herbison A.E. Sex differences in the regulation of tyrosine hydroxylase gene transcription by estrogen in the locus coeruleus of TH9-LacZ transgenic mice // Brain. Res. Mol. Brain. Res. 2002. Vol. 104. P. 220–226.

47. Tsuchihashi K., Ueshima K., Uchida T. et al. Transient left ventricular apical ballooning without coronary artery stenosis: A novel heart syndrome mimicking acute myocardial infarction. Angina pectoris-myocardial infarction investigations in Japan // J. Am. Coll. Cardiol. 2001. Vol. 38. P. 11–18.

48. 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. P. 371–377.

49. Ueyama T., Ishikura F., Matsuda A. et al. Chronic estrogen supplementation following ovariectomy improves the emotional stress-induced cardiovascular responses by indirect action on the nervous system and by direct action on the heart // Circ. J. 2007. Vol. 71. P. 565–573.

50. Upadya S.P., Hoq S.M., Pannala R. et al. Tako tsubo cardiomyopathy (transient left ventricular apical ballooning): Case report of a myocardial perfusion echocardiogram study // J. Am. Soc. Echocardiogr. 2005. Vol. 18. P. 883.

51. Vasilieva E., Urazovskaya I., Skrypnik D. et al. 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. P. 155–159.

52. 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.

53. Wilbert-Lampen U., Trapp A., Modrzik M. et al. Effects of corticotropin-releasing hormone (CRH) on endothelin-1 and NO release, mediated by CRH receptor subtype R2: A potential link between stress and endothelial dysfunction? // J. Psychosom. Res. 2006. Vol. 61. P. 453–460.

54. Yoshida T., Hibino T., Kako N. et al. A pathophysiologic study of tako-tsubo cardiomyopathy with F-18 fluorodeoxyglucose positron emission tomography // Eur. Heart J. 2007. Vol. 28. P. 2598–2604.

Электронная подписка

Для получения доступа к тексту статей журнала воспользуйтесь услугой «Электронная подписка»:

Оформить подписку Подробнее об электронной подписке

Главный редактор

Лео Антонович Бокерия, академик РАН и РАМН

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, директор


 Если вы заметили опечатку, выделите текст и нажмите alt+A