New mechanisms underlying Takotsubo syndrome, often dubbed 'brokenheartsyndrome,' are suggested from hemodynamic studies, which could lead to new treatment strategies for the condition. MedEd CardioTwitter
For the study, the researchers used a conductance catheter inserted into the left ventricle of the heart to analyze pressure-volume relationships in 24 consecutive patients with Takotsubo syndrome and a control population of 20 participants without cardiovascular disease.
Results showed that Takotsubo syndrome is associated with a severely impaired cardiac contractility and a shortened systolic period. In response, the heart compensates by increasing left ventricular end diastolic volume to preserve theDiastolic function is characterized by prolonged active relaxation but unaltered passive elastic properties. The analysis of myocardial energetics revealed an inefficient system with increased potential and decreased kinetic energy .
The researchers suggest that Takotsubo syndrome may therefore be treated with medications such as omecamtiv or the calcium sensitizer levosimendan, which improves contractility, possibly in combination with beta-blockers to protect against the intense adrenergic activation. He explained that the contractile abnormalities in Takotsubo syndrome are transient and generally normalize after a few weeks or months, but while systolic function may appear normal in the long term there are other more subtle changes that can persist, and these patients have an increased rate of cardiovascular events compared with the healthy population over the long term.
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