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首页> 外文期刊>The American Journal of Cardiology >Relation of Delayed Recovery of Myocardial Function After Takotsubo Cardiomyopathy to Subsequent Quality of Life
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Relation of Delayed Recovery of Myocardial Function After Takotsubo Cardiomyopathy to Subsequent Quality of Life

机译：Takotsubo心肌病后心肌功能延迟恢复与随后生活质量的关系

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Takotsubo cardiomyopathy (TTC) has generally been regarded as a relatively transient disorder, characterized by reversible regional left ventricular systolic dysfunction. However, most patients with TTC experience prolonged lassitude or dyspnea after acute attacks. Although this might reflect continued emotional stress, myocardial inflammation and accentuated brain-type natriuretic peptide (BNP) release persist for at least 3 months. We therefore tested the hypotheses that this continued inflammation is associated with (1) persistent contractile dysfunction and (2) consequent impairment of quality of life. Echocardiographic parameters (global longitudinal strain [GLS], longitudinal strain rate [LSR], and peak apical twist [AT]) were compared acutely and after 3 months in 36 female patients with TTC and 19 age-matched female controls. Furthermore, correlations were sought between putative functional anomalies, inflammatory markers (T2 score on cardiovascular magnetic resonance, plasma NT-proBNP, and high-sensitivity C-reactive protein levels), and the physical composite component of SF36 score (SF36-PCS). In TTC cases, left ventricular ejection fraction returned to normal within 3 months. GLS, LSR, and AT improved significantly over 3-month recovery, but GLS remained reduced compared to controls even at follow-up (-17.+/- 9 3.1% vs 20.0 +/- 1.8%, p = 0.003). Impaired GLS at 3 months was associated with both persistent NT-proBNP elevation (p = 0.03) and reduced SF36-PCS at >= 3 months (p = 0.04). In conclusion, despite normalization of left ventricular ejection fraction, GLS remains impaired for at least 3 months, possibly as a result of residual myocardial inflammation. Furthermore, perception of impaired physical exercise capacity >= 3 months after TTC may be explained by persistent myocardial dysfunction. (C) 2015 Elsevier Inc. All rights reserved.
机译：Takotsubo心肌病（TTC）通常被认为是一种相对短暂的疾病，其特征是可逆性区域性左心室收缩功能障碍。但是，大多数患有TTC的患者在急性发作后会经历长时间的倦怠或呼吸困难。尽管这可能反映出持续的情绪压力，但心肌炎症和脑型利钠肽（BNP）的释放持续至少3个月。因此，我们检验了这种持续发炎与（1）持续性收缩功能障碍和（2）随之而来的生活质量损害相关的假设。在36例TTC女性患者和19例年龄相匹配的女性对照中，分别对3个月后的超声心动图参数（总体纵向应变[GLS]，纵向应变率[LSR]和顶尖扭转[AT]）进行了比较。此外，在推测的功能异常，炎症标记（心血管磁共振的T2评分，血浆NT-proBNP和高敏感性C反应蛋白水平）与SF36评分的物理复合成分（SF36-PCS）之间寻求相关性。在TTC病例中，左心室射血分数在3个月内恢复正常。经过3个月的恢复，GLS，LSR和AT明显改善，但即使在随访时，GLS仍比对照组降低（-17。+ /-9 3.1％vs 20.0 +/- 1.8％，p = 0.003）。 3个月时GLS受损与持续NT-proBNP升高（p = 0.03）和> = 3个月时SF36-PCS降低（p = 0.04）有关。总之，尽管左心室射血分数恢复正常，但GLS至少受损3个月，这可能是由于残留的心肌炎症所致。此外，TTC后≥3个月的体育锻炼能力受损的感觉可能由持续的心肌功能障碍所解释。 （C）2015 Elsevier Inc.保留所有权利。

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