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. 2022 Feb;32(1):9-17.
doi: 10.1007/s10286-021-00844-z. Epub 2022 Jan 8.

The role of central autonomic nervous system dysfunction in Takotsubo syndrome: a systematic review

Vojtech Brazdil #  1   2 , Petr Kala #  3   4 , Martin Hudec  1   2 , Martin Poloczek  1 , Jan Kanovsky  1   2 , Roman Stipal  1 , Petr Jerabek  1 , Otakar Bocek  1   2 , Martin Pail  2   5 , Milan Brazdil  2   5
Affiliations

The role of central autonomic nervous system dysfunction in Takotsubo syndrome: a systematic review

Vojtech Brazdil et al. Clin Auton Res. 2022 Feb.

Abstract

Introduction: Takotsubo syndrome (TTS), also known as stress cardiomyopathy or "broken heart" syndrome, is a mysterious condition that often mimics an acute myocardial infarction. Both are characterized by left ventricular systolic dysfunction. However, this dysfunction is reversible in the majority of TTS patients.

Purpose: Recent studies surprisingly demonstrated that TTS, initially perceived as a benign condition, has a long-term prognosis akin to myocardial infarction. Therefore, the health consequences and societal impact of TTS are not trivial. The pathophysiological mechanisms of TTS are not yet completely understood. In the last decade, attention has been increasingly focused on the putative role of the central nervous system in the pathogenesis of TTS.

Conclusion: In this review, we aim to summarize the state of the art in the field of the brain-heart axis, regional structural and functional brain abnormalities, and connectivity aberrancies in TTS.

Keywords: Amygdala; Brain connectivity; Brain–heart axis; Insular cortex; Takotsubo syndrome.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Left ventriculogram in acute TTS. a Diastole; b systole. Images demonstrate systolic dysfunction with hyperkinesis in the basal segments and akinesis of the apical and midventricular segments
Fig. 2
Fig. 2
Flow diagram according to PRISMA guidelines for systematic review of the literature
See this image and copyright information in PMC

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