Takotsubo Syndrome in Patients with COVID-19: a Systematic Review of Published Cases

SN Comprehensive Clinical Medicine - Tập 2 Số 11 - Trang 2102-2108 - 2020
Sandeep Singh1, Rupak Desai2, Zainab Gandhi3, Hee Kong Fong4, Shriya Doreswamy5, Virmitra Desai6, Anand Chockalingam7, Puja K. Mehta8, Rajesh Sachdeva9, Gautam Kumar8
1Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Center, AMC, Amsterdam, Netherlands
2Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, USA
3Department of Internal Medicine, Geisinger Community Medical Center, Scranton, PA, USA
4Division of Cardiology, UC Davis Medical Center, Sacramento, CA, USA
5Vydehi Institute of Medical Sciences and Research Centre, Bangalore, India
6University of North Texas Health Science Center, Fort Worth, TX, USA
7Division of Cardiology, University of Missouri Health Care, Columbia, MO, USA
8Division of Cardiology, Emory University School of Medicine, Atlanta, GA USA
9Division of Cardiology, Morehouse School of Medicine, Atlanta, GA, USA

Tóm tắt

AbstractTakotsubo syndrome (TTS) is caused by catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed/Medline, SCOPUS, Web of Science, and Google Scholar databases to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, clinical attributes, and outcomes. There are 12 cases reported of TTS associated with COVID-19 infection with mean age of 70.8 ± 15.2 years (range 43–87 years) with elderly (66.6% > 60 years) female (66.6%) majority. The time interval from the first symptom to TTS was 8.3 ± 3.6 days (range 3–14 days). Out of 12 cases, 7 reported apical ballooning, 4 reported basal segment hypo/akinesia, and 1 reported median TTS. Out of 12 cases, during hospitalization, data on left ventricular ejection fraction (LVEF) was reported in only 9 of the cases. The mean LVEF was 40.6 ± 9.9% (male, 46.7 ± 5.7%, and female, 37.7 ± 10.6%). Troponin was measured in all 12 cases and was elevated in 11 (91.6%) without stenosis on coronary angiography except one. Out of 11 cases, 6 developed cardiac complications with 1 case each of cardiac tamponade, heart failure, myocarditis, hypertensive crisis, and cardiogenic shock in 2. Five patients required intubation, 1 patient required continuous positive airway pressure, and 1 patient required venovenous extracorporeal membrane oxygenation. The outcome was reported in terms of recovery in 11 (91.6%) out of 12 cases, and a successful recovery was noted in 10 (90.9%) cases. COVID-19-related TTS has a higher prevalence in older women. Despite a lower prevalence of cardiac comorbidities in COVID-19 patients, direct myocardial injury, inflammation, and stress may contribute to TTS with a high complication rate.

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Tài liệu tham khảo

Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, et al. Clinical features and outcomes of takotsubo (stress) cardiomyopathy. N Engl J Med. 2015;373:929–38.

Wittstein IS, Thiemann DR, Lima JAC, Baughman KL, Schulman SP, Gerstenblith G, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med. 2005;352:539–48.

Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5:802–10.

Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5:811–8.

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.

Shi S, Qin M, Cai Y, Liu T, Shen B, Yang F, et al. Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019. Eur Heart J. 2020;41:2070–9.

Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395:1033–4.

Staedtke V, Bai R-Y, Kim K, Darvas M, Davila ML, Riggins GJ, et al. Disruption of a self-amplifying catecholamine loop reduces cytokine release syndrome. Nature. 2018;564:273–7.

Moderato L, Monello A, Lazzeroni D, Binno S, Giacalone R, Ferraro S, et al. Takotsubo syndrome during SARS-CoV-2 pneumonia: a possible cardiovascular complication. G Ital Cardiol. 2020;21:417–20.

Dabbagh MF, Aurora L, D’Souza P, Weinmann AJ, Bhargava P, Basir MB. Cardiac tamponade secondary to COVID-19. JACC Case Rep. 2020;2:1326–30.

Meyer P, Degrauwe S, Van Delden C, Ghadri JR, Templin C. Typical takotsubo syndrome triggered by SARS-CoV-2 infection. Eur Heart J. 2020;41:1860.

Minhas AS, Scheel P, Garibaldi B, Liu G, Horton M, Jennings M, et al. Takotsubo syndrome in the setting of COVID-19 infection. JACC Case Rep. 2020;2:1321–5.

Nguyen D, Nguyen T, De Bels D, Castro RJ. A case of takotsubo cardiomyopathy with COVID 19. Eur Heart J Cardiovasc Imaging. 2020;21:1052.

Roca E, Lombardi C, Campana M, Vivaldi O, Bigni B, Bertozzi B, et al. Takotsubo syndrome associated with COVID-19. Eur J Case Rep Intern Med. 2020;7:001665.

Sala S, Peretto G, Gramegna M, Palmisano A, Villatore A, Vignale D, et al. Acute myocarditis presenting as a reverse Tako-Tsubo syndrome in a patient with SARS-CoV-2 respiratory infection. Eur Heart J. 2020;41:1861–2.

Solano-López J, Sánchez-Recalde A, Zamorano JL. SARS-CoV-2, a novel virus with an unusual cardiac feature: inverted takotsubo syndrome. Eur Heart J. 2020;41:3106.

Pasqualetto MC, Secco E, Nizzetto M, Scevola M, Altafini L, Cester A, et al. Stress Cardiomyopathy in COVID-19 Disease. Eur J Case Rep Intern Med. 2020;7:001718.

Taza F, Zulty M, Kanwal A, Grove D. Takotsubo cardiomyopathy triggered by SARS-CoV-2 infection in a critically ill patient. BMJ Case Rep. 2020;13:e236561.

Kato K, Lyon AR, Ghadri J-R, Templin C. Takotsubo syndrome: aetiology, presentation and treatment. Heart. 2017;103:1461–9.

Ueyama T, Hano T, Kasamatsu K, Yamamoto K, Tsuruo Y, Nishio I. Estrogen attenuates the emotional stress-induced cardiac responses in the animal model of Tako-tsubo (ampulla) cardiomyopathy. J Cardiovasc Pharmacol. 2003;42(Suppl 1):S117–9.

Rivers J, Ihle JF. COVID-19 social isolation-induced takotsubo cardiomyopathy. Med J Aust. n/a.

Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002;106:2067–72.

Gianni M, Dentali F, Grandi AM, Sumner G, Hiralal R, Lonn E. Apical ballooning syndrome or takotsubo cardiomyopathy: a systematic review. Eur Heart J. 2006;27:1523–9.

Bernardi N, Calvi E, Cimino G, Pascariello G, Nardi M, Cani D, et al. COVID-19 pneumonia, takotsubo syndrome, and left ventricle thrombi. JACC Case Rep. 2020;2:1359–64.

Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. Eur Heart J. 2010;32:404–11.

Ramaraj R, Sorrell VL, Movahed MR. Levels of troponin release can aid in the early exclusion of stress-induced (takotsubo) cardiomyopathy. Exp Clin Cardiol. 2009;14:6–8.

Ghadri JR, Kato K, Cammann VL, Gili S, Jurisic S, Di Vece D, et al. Long-term prognosis of patients with takotsubo syndrome. J Am Coll Cardiol. 2018;72:874–82.

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SN Comprehensive Clinical Medicine

Tập 2 Số 11

2102-2108

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