Details

Autor(en) / Beteiligte

• Scally, Caroline
• Ahearn, Trevor
• Srinivasan, Janaki
• Mezincescu, Alice M
• Rudd, Amelia
• Abbas, Hassan
• Spath, Nicholas B
• Yucel-Finn, Alim
• Yuecel, Raif
• Dospinescu, Ciprian
• Horgan, Graham
• Broadhurst, Paul
• Henning, Anke
• Newby, David E
• Semple, Scott I
• Wilson, Heather M
• Dawson, Dana K

Titel

Abstract 13152: Myocardial and Systemic Inflammationin Acute Stress-Induced (Takotsubo) Cardiomyopathy

Ist Teil von

• Circulation (New York, N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A13152-A13152

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek (Open access)

Beschreibungen/Notizen

• BackgroundAcute stress induced (takotsubo) cardiomyopathy can result in a heart failure phenotype with a prognosis comparable to myocardial infarction. In this study, we hypothesized that inflammation is central to the pathophysiology and natural history of takotsubo cardiomyopathy.MethodsWe prospectively recruited 53 patients with takotsubo cardiomyopathy and 50 age, sex and co-morbidity matched control subjects. During the index event and at 5 months follow-up, takotsubo patients underwent multiparametric cardiac magnetic resonance imaging including ultrasmall superparamagnetic particles of iron oxide (USPIO) enhancement. Blood monocyte subpopulations and serum cytokines were assessed as measures of systemic inflammation. Matched controls underwent investigation at a single time point.ResultsSubjects were predominantly middle aged (65±13years) women (90%). When compared to control subjects, patients with takotsubo cardiomyopathy had greater USPIO enhancement (expressed as the difference between pre-USPIO and post-USPIO T2*) in both ballooning (14.5±0.6 vs 10.5±0.9 ms, p≤0.001) and non-ballooning (12.7±0.6 vs 10.5±0.9 ms, p=0.05) left ventricular myocardial segments. Serum interleukin-6 (23.1±4.5 vs 6.5±5.8 pg/mL, p< 0.001) and growth-regulated protein (1903±168 vs 1272±177 pg/mL, p=0.01) concentrations, and classical CD14CD16 monocytes (90±0.5 vs 87±0.9%, p=0.006) were also increased whilst intermediate CD14CD16 (5.3±0.3 vs 6.9±0.6%, p=0.01) and non-classical CD14CD16 (2.7±0.3% vs 4.2±0.5%, p=0.004) monocytes were reduced in patients with takotsubo cardiomyopathy. At 5 months, USPIO enhancement was no longer detectable in the left ventricular myocardium although there remained persistent elevations in serum interleukin-6 concentrations (p=0.009) and reductions in intermediate CD14CD16 monocytes (5.6±0.4 vs 6.9±0.6%, p=0.02).ConclusionsWe demonstrate for the first time that takotsubo cardiomyopathy is characterized by myocardial cellular inflammation, and systemic cellular and cytokine activation. Many of these changes persisted for up to 5 months suggesting a low-grade chronic inflammatory state.