Pathophysiology of Takotsubo syndrome - a joint scientific statement from the Heart Failure Association Takotsubo Syndrome Study Group and Myocardial Function Working Group of the European Society of Cardiology - Part 1: overview and the central role for catecholamines and sympathetic nervous system

Omerovic, Elmir; Citro, Rodolfo; Bossone, Eduardo; Redfors, Bjorn; Backs, Johannes; Bruns, Bastian; Ciccarelli, Michele; Couch, Liam S; Dawson, Dana; Grassi, Guido; Iacoviello, Massimo; Parodi, Guido; Schneider, Birke; Templin, Christian; Ghadri, Jelena R; Thum, Thomas; Chioncel, Ovidiu; Tocchetti, C Gabriele; van der Velden, Jolanda; Heymans, Stephane; Lyon, Alexander R

doi:10.1002/ejhf.2400

Pathophysiology of Takotsubo syndrome - a joint scientific statement from the Heart Failure Association Takotsubo Syndrome Study Group and Myocardial Function Working Group of the European Society of Cardiology - Part 1: overview and the central role for catecholamines and sympathetic nervous system

Author:

Omerovic, Elmir

Citro, Rodolfo ; Bossone, Eduardo ; Redfors, Bjorn ; Backs, Johannes ; Bruns, Bastian ; Ciccarelli, Michele ; Couch, Liam S ; Dawson, Dana ; Grassi, Guido ; Iacoviello, Massimo ; Parodi, Guido ; Schneider, Birke ; Templin, Christian ; Ghadri, Jelena R ; Thum, Thomas ; Chioncel, Ovidiu ; Tocchetti, C Gabriele ; van der Velden, Jolanda ; Heymans, Stephane ; Lyon, Alexander R

Keywords:

BALLOONING SYNDROME, Beta-adrenergic signalling, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Catecholamine, CLINICAL-FEATURES, COUPLED-RECEPTOR KINASE-5, DIAGNOSTIC-CRITERIA, Electrophysiology, G-protein coupled receptor kinase, Inflammation, Life Sciences & Biomedicine, LIFE-THREATENING ARRHYTHMIAS, Metabolism, NATRIURETIC PEPTIDE, Pathophysiology, QT INTERVAL PROLONGATION, Science & Technology, STRESS-INDUCED CARDIOMYOPATHY, TAKO-TSUBO CARDIOMYOPATHY, Takotsubo syndrome, VENTRICULAR DYSFUNCTION, Cardiology, Catecholamines, Heart Failure, Humans, Sympathetic Nervous System, Takotsubo Cardiomyopathy, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, 3201 Cardiovascular medicine and haematology

Abstract:

This is the first part of a scientific statement from the Heart Failure Association (HFA) of the European Society of Cardiology focused upon the pathophysiology of Takotsubo syndrome and is complimentary to the previous HFA position statement on Takotsubo syndrome which focused upon clinical management. In part 1 we provide an overview of the pathophysiology of Takotsubo syndrome and fundamental questions to consider. We then review and discuss the central role of catecholamines and the sympathetic nervous system in the pathophysiology, and the direct effects of high surges in catecholamines upon myocardial biology including β-adrenergic receptor signalling, G-protein coupled receptor kinases, cardiomyocyte calcium physiology, myofilament physiology, cardiomyocyte gene expression, myocardial electrophysiology and arrhythmogenicity, myocardial inflammation, metabolism and energetics. The integrated effects upon ventricular haemodynamics are discussed and integrated into the pathophysiological model.