Cardiogenic Shock in Takotsubo Syndrome, a Systematic Review

Authors

DOI:

https://doi.org/10.62486/agsalud202364

Keywords:

Takotsubo Cardiomyopathy, Shock, Cardiogenic, Therapeutics, Complications

Abstract

Background: Takotsubo syndrome is a cardiomyopathy induced by physical or emotional stress, characterized by ventricular apical dilatation, knowledge of the pathophysiological mechanisms of the disease is still incomplete. The most widely accepted hypothesis today is that excess catecholamines cause calcium overload in cardiac myocytes, which leads to interruption of contraction and ventricular function. Material and methods: A synthesis of the available evidence about takotsubo syndrome was carried out through a systematic review type study and the maximum number of articles that reported cases of treatment of this entity was included. For this, specific searches were launched with MESH type keywords. Results: 12 articles were selected. This included a total of 351,124 patients with Takotsubo syndrome, with a mean of 70,224 per study, of whom 5.82% (20,418 of 351,124) were complicated by cardiogenic shock. Among the risk factors associated with cardiogenic shock were found: Use of drugs such as cocaine, peaks of emotional stress, physical stress from surgeries, menopause, hypoglycemia, massive blood loss, hypotension and use of drugs such as atropine, adrenaline, dobutamine, ergonovine, nortriptyline. Conclusion: From the analysis of the results obtained, physical and mental stress are risk factors associated with cardiogenic shock in patients with Takotsubo syndrome, this corresponds to the most accepted hypothesis today that justifies this syndrome with the excess in the production of catecholamines, hormones secreted under stress

References

1. Tewelde SZ, Liu SS, Winters ME. Cardiogenic Shock. Cardiol Clin. 2018 Feb;36(1):53-61. doi: 10.1016/j.ccl.2017.08.009. PMID: 29173681.

2. Vista de Actualización de cardiomiopatía de Takotsubo | Revista Medica Sinergia [Internet]. [citado 13 de octubre de 2022]. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/441/804

3. Cardiogenic shock induced by Takotsubo cardiomyopathy: A new therapeutic option | Revista Portuguesa de Cardiologia [Internet]. [citado 13 de octubre de 2022]. Disponible en: https://www.revportcardiol.org/pt-cardiogenic-shock-induced-by-takotsubo-articulo-S0870255115002449

4. Miocardiopatía de Takotsubo: Fisiopatología, diagnóstico y tratamiento - PMC [Internet]. [citado 14 de octubre de 2022]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110608/

5. Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management - PubMed [Internet]. [citado 13 de octubre de 2022]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35002350/

6. Pathophysiology of Takotsubo Syndrome: JACC State-of-the-Art Review | Journal of the American College of Cardiology [Internet]. [citado 13 de octubre de 2022]. Disponible en: https://www.jacc.org/doi/10.1016/j.jacc.2020.10.060

7. Vista de Síndrome de Takotsubo: Fisiopatología, manifestaciones clínicas y diagnóstico | Journal of American Health [Internet]. [citado 13 de octubre de 2022]. Disponible en: https://www.jah-journal.com/index.php/jah/article/view/57/128

8. Takotsubo cardiomyopathy: a review of literature on clinical status and meta-analysis of diagnosis and medical therapy [Internet]. [citado 17 de octubre de 2022]. Disponible en: https://www.oatext.com/takotsubo-cardiomyopathy-a-review-of-literature-on-clinical-status-and-meta-analysis-of-diagnosis-and-medical-therapy.php

9. Balón de contrapulsación e inotrópicos no catecolamínicos en el manejo del shock cardiogénico secundario a cardiopatía de Takotsubo: Una serie de casos [Internet]. [citado 13 de octubre de 2022]. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1852-38622015000400003

10. Síndrome de Takotsubo en la población pediátrica: reporte de un caso y revisión sistemática - PubMed [Internet]. [citado 14 de octubre de 2022]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27673581/

11. Mirando más profundamente en el corazón de Takotsubo | Investigación Cardiovascular | Académico de Oxford [Internet]. [citado 17 de octubre de 2022]. Disponible en: https://academic.oup.com/cardiovascres/article/118/8/1851/6586239?login=false

12. Bietry R, Reyentovich A, Katz SD. Clinical management of takotsubo cardiomyopathy. Heart Fail Clin. 2013 Apr;9(2):177-86, viii. doi: 10.1016/j.hfc.2012.12.003. PMID: 23562118.

13. Doyen D, Dellamonica J, Moceri P, Moschietto S, Hyvernat H, Ferrari E, Bernardin G. Tako-Tsubo cardiomyopathy presenting with cardiogenic shock successfully treated with milrinone: a case report. Heart Lung. 2014 Jul-Aug;43(4):331-3. doi: 10.1016/j.hrtlng.2014.03.007. Epub 2014 Apr 18. PMID: 24746945.

14. Said SM, Albouaini K, Herold J, Hahn J, Brucks S, Schmidt H, Schmeisser A, Prondzinsky R, Braun-Dullaeus RC. Das Takotsubo-Syndrom von der Erstbeschreibung bis heute [Takotsubo syndrome from original description up to now]. Med Klin (Munich). 2009 Jun 15;104(6):434-40. German. doi: 10.1007/s00063-009-1092-9. Epub 2009 Jun 16. PMID: 19533050.

15. Shimizu K, Ogura H, Wasa M, Hirose T, Shimazu T, Nagasaka H, Hirano K. Refractory hypoglycemia and subsequent cardiogenic shock in starvation and refeeding: report of three cases. Nutrition. 2014 Sep;30(9):1090-2. doi: 10.1016/j.nut.2014.01.007. Epub 2014 Feb 15. PMID: 24927630.

16. Papanikolaou J, Makris D, Tsolaki V, Spathoulas K, Zakynthinos E. Post-partum hemorrhage complicated by reverse-Takotsubo cardiogenic shock; a novel therapeutic approach. Am J Emerg Med. 2017 Jun;35(6):935.e1-935.e3. doi: 10.1016/j.ajem.2016.12.034. Epub 2016 Dec 19. PMID: 28012808.

17. Cardinale M, Esnault P, Schmitt J, Meaudre E. Transient Left Ventricular Acute Failure after Cocaine Use. Curr Drug Res Rev. 2019;11(2):142-144. doi: 10.2174/2589977511666190716111303. PMID: 31333135.

18. Y-Hassan S, Tornvall P, Törnerud M, Henareh L. Capecitabine caused cardiogenic shock through induction of global Takotsubo syndrome. Cardiovasc Revasc Med. 2013 Jan-Feb;14(1):57-61. doi: 10.1016/j.carrev.2012.10.001. Epub 2012 Dec 5. PMID: 23218901.

19. Di Palma G, Daniele GP, Antonini-Canterin F, Piazza R, Nicolosi GL. Cardiogenic shock with basal transient left ventricular ballooning (Takotsubo-like cardiomyopathy) as first presentation of pheochromocytoma. J Cardiovasc Med (Hagerstown). 2010 Jul;11(7):507-10. doi: 10.2459/JCM.0b013e32832b4ccc. PMID: 20407387.

20. Samardhi H, Raffel OC, Savage M, Sirisena T, Bett N, Pincus M, Small A, Walters DL. Takotsubo cardiomyopathy: an Australian single centre experience with medium term follow up. Intern Med J. 2012 Jan;42(1):35-42. doi: 10.1111/j.1445-5994.2011.02474.x. PMID: 21395961.

21. Abe Y, Tamura A, Kadota J. Prolonged cardiogenic shock caused by a high-dose intravenous administration of dopamine in a patient with takotsubo cardiomyopathy. Int J Cardiol. 2010 May 14;141(1):e1-3. doi: 10.1016/j.ijcard.2008.11.123. Epub 2009 Jan 9. PMID: 19135739.

22. Vallabhajosyula S, Dunlay SM, Murphree DH Jr, Barsness GW, Sandhu GS, Lerman A, Prasad A. Cardiogenic Shock in Takotsubo Cardiomyopathy Versus Acute Myocardial Infarction: An 8-Year National Perspective on Clinical Characteristics, Management, and Outcomes. JACC Heart Fail. 2019 Jun;7(6):469-476. doi: 10.1016/j.jchf.2018.12.007. Epub 2019 May 8. PMID: 31078481.

23. Syed M, Khan MZ, Osman M, Alharbi A, Khan MU, Munir MB, Balla S. Comparison of Outcomes in Patients With Takotsubo Syndrome With-vs-Without Cardiogenic Shock. Am J Cardiol. 2020 Dec 1;136:24-31. doi: 10.1016/j.amjcard.2020.09.014. Epub 2020 Sep 15. PMID: 32941812; PMCID: PMC8375056.

24. Di Palma G, Daniele GP, Antonini-Canterin F, Piazza R, Nicolosi GL. Cardiogenic shock with basal transient left ventricular ballooning (Takotsubo-like cardiomyopathy) as first presentation of pheochromocytoma. J Cardiovasc Med (Hagerstown). 2010 Jul;11(7):507-10. doi: 10.2459/JCM.0b013e32832b4ccc. PMID: 20407387.

25. Di Vece D, Citro R, Cammann VL, Kato K, Gili S, Szawan KA, Micek J, Jurisic S, Ding KJ, Bacchi B, Schwyzer M, Candreva A, Bossone E, D'Ascenzo F, Sarcon A, Franke J, Napp LC, Jaguszewski M, Noutsias M, Münzel T, Knorr M, Heiner S, Katus HA, Burgdorf C, Schunkert H, Thiele H, Bauersachs J, Tschöpe C, Pieske BM, Rajan L, Michels G, Pfister R, Cuneo A, Jacobshagen C, Hasenfuβ G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Banning A, Cuculi F, Kobza R, Fischer TA, Vasankari T, Airaksinen KEJ, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Empen K, Felix SB, Delmas C, Lairez O, El-Battrawy I, Akin I, Borggrefe M, Gilyarova E, Shilova A, Gilyarov M, Horowitz J, Kozel M, Tousek P, Widimský P, Winchester DE, Ukena C, Di Mario C, Prasad A, Böhm M, Bax JJ, Lüscher TF, Ruschitzka F, Ghadri JR, Templin C. Outcomes Associated With Cardiogenic Shock in Takotsubo Syndrome. Circulation. 2019 Jan 15;139(3):413-415. doi: 10.1161/CIRCULATIONAHA.118.036164. PMID: 30586690

Downloads

Published

2024-05-22

Issue

Section

Systematic reviews or meta-analyses

How to Cite

1.
Franca R, Levin R. Cardiogenic Shock in Takotsubo Syndrome, a Systematic Review. AG Salud [Internet]. 2024 May 22 [cited 2025 Sep. 5];1:64. Available from: https://agsalud.ageditor.org/index.php/agsalud/article/view/25