alexa Tako-tsubo cardiomyopathy and microcirculation.


Journal of Clinical & Experimental Cardiology

Author(s): Fazio G, Sarullo FM, Novo G, Evola S, Lunetta M,

Abstract Share this page

Abstract BACKGROUND: Takotsubo cardiomyopathy was described for the first time in Japan in the 1990s. It is very similar to the ischemic cardiopathy both for clinical and instrumental characteristics. His peculiarity is an alteration of the ventricular contraction mechanism with hypo-akinesis of the apex and lateral segments of the left ventricle, associated with hyper-kinesis of the heart base which is responsible for the typical echocardiographic aspect of a cruet during the systole. However, the etiology of this cardiomyopathy is still unknown despite the fact that numerous hypothesis have been made. A single study of 16 patients proved multivasal damage by a BLASH SCORE analysis of the coronary radiography. In our study, performed on 24 patients, we intended to assess the actual implication of the microcirculation by analyzing the TIMI frame count (TFC), so as reporting correlations between alterations of each single artery and its respective myocardial area. METHODS AND RESULTS: Six Cardiology Centres performed an International multi-centre collection of a consecutive series of 24 patients, of which 20 were women and four men. The average age was 67.4 years. All patients admitted to one of the Cardiology divisions were previously listed for symptoms and signs of Takotsubo cardiomyopathy. An electrocardiographic (ECG), echocardio-gram and a hemodynamic study were carried out on each patient. The patients were evaluated with a follow up lasting 7 weeks. On the coronary radiography film, the microcirculation was examined by an analysis of the TFC according to the Gibson technique. The value obtained was considered pathological if it was >30 frames. The evaluation of the microcirculation by the TFC analysis showed that in 23 of the 24 patients there was a pathological slow down of the flow in the coronary micro- circulation. By analysing the number of involved vessels it was noted that nine patients had a slowdown of the general flow in all three vessels, six patients in only two vessels and the remaining nine in one vessel. In particular: in 14 patients there was an abnormal TFC in left anterior descending coronary artery (LAD), 16 in the right coronary artery (RCA) and 18 in the left circumflex coronary artery (LCX), while in one patient the picture quality in the acute phase did not allow an evaluation of the score in the RCA and in another patient in the LDA. None of the explored vessels that was responsible for the disorder of the microcirculation showed any stenosis. CONCLUSION: From the data evaluated by us, microcirculatory dysfunction seems to be present very often during acute phases of Takotsubo illness, but it is not the only determining factor of the illness. This article was published in J Clin Monit Comput and referenced in Journal of Clinical & Experimental Cardiology

Relevant Expert PPTs

Relevant Speaker PPTs

  • Donald silverberg
    Is correction of iron deficiency a new addition to the treatment of heart failure?
    PPT Version | PDF Version
  • Ahmed Zeidan
    Effects of intravenous iron in chronic kidney disease and heart failure
    PPT Version | PDF Version
  • Nicolae Bacalbasa
    The benefits of surgery for breast cancer liver metastases – a single center experience
    PPT Version | PDF Version
  • Suzi Demirbag
    Indications and effectiveness of the open surgery in vesicoureteral refl ux
    PPT Version | PDF Version
  • Mehmet Ozler
    “Mehmet Ozler-Gulhane-Military-Medical-Academy-Ankara-Turkey-Pinealectomy-Initiates-the-Oxidative-Stress-Response-in-Brain-Tissue-of-Rats-Subject-to-Abdominal-Surgery”
    PPT Version | PDF Version
  • Yosef Yarden
    Classically, the 3’untranslated region (3’UTR) is that region in eukaryotic protein-coding genes from the translation termination codon to the polyA signal. It is transcribed as an integral part of the mRNA encoded by the gene. However, there exists another kind of RNA, which consists of the 3’UTR alone, without all other elements in mRNA such as 5’UTR and coding region. The importance of independent 3’UTR RNA (referred as I3’UTR) was prompted by results of artificially introducing such RNA species into malignant mammalian cells. Since 1991, we found that the middle part of the 3’UTR of the human nuclear factor for interleukin-6 (NF-IL6) or C/EBP gene exerted tumor suppression effect in vivo. Our subsequent studies showed that transfection of C/EBP 3’UTR led to down-regulation of several genes favorable for malignancy and to up-regulation of some genes favorable for phenotypic reversion. Also, it was shown that the sequences near the termini of the C/EBP 3’UTR were important for its tumor suppression activity. Then, the C/EBP 3’UTR was found to directly inhibit the phosphorylation activity of protein kinase CPKC in SMMC-7721, a hepatocarcinoma cell line. Recently, an AU-rich region in the C/EBP 3’UTR was found also to be responsible for its tumor suppression. Recently we have also found evidence that the independent C/EBP 3’UTR RNA is actually exists in human tissues, such as fetal liver and heart, pregnant uterus, senescent fibroblasts etc. Through 1990’s to 2000’s, world scientists found several 3’UTR RNAs that functioned as artificial independent RNAs in cancer cells and resulted in tumor suppression. Interestingly, majority of genes for these RNAs have promoter-like structures in their 3’UTR regions, although the existence of their transcribed products as independent 3’UTR RNAs is still to be confirmed. Our studies indicate that the independent 3’UTR RNA is a novel non-coding RNA species whose function should be the regulation not of the expression of their original mRNA, but of some essential life activities of the cell as a whole.
    PPT Version | PDF Version
  • Alina Borowska
    Postoperative cognitive dysfunctions after cardiac operations
    PPT Version | PDF Version
  • Ana Domingo Rueda
    Collaborative programme in Pediatric Cardiac Surgery in Ethiopia: Nursery role
    PPT Version | PDF Version
  • Manuele Casale
    The potential role of hyaluronic acid in postoperative radiofrequency surgery for chronic inferior turbinate hypertrophy
    PPT Version | PDF Version
  • Wenru Wang
    Effects of home-based cardiac rehabilitation programme for patients with acute myocardial infarction: A randomized controlled trail
    PPT Version | PDF Version
  • Cicek Senture
    Analyzing The Efficiencies Of Discharge Education For The Patients Who Had A Cardiac Surgery
    PPT Version | PDF Version
  • Femi Ehizokhale Osho
    Pain management for surgery and anesthesia
    PPT Version | PDF Version
  • Jean Daniel Eloy
    Surgery Under Regional Anesthesia
    PPT Version | PDF Version
  • Bonnie Molloy, Scott Thornton, Daniel Silasi
    Preventive Anesthesia and Surgical Treatment Interventions during Robotics and Steep Trendelenburg Positioned Surgery
    PPT Version | PDF Version
  • Samar Jabbour-Khoury
    Anesthesia for bariatric surgery: What the occasional anesthesiologist should know
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version