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Heart and lung, a dangerous liaison-Tako-tsubo cardiomyopathy and respiratory diseases: A systematic review
Roberto Manfredini, Fabio Fabbian, Alfredo De Giorgi, Marco Pala, Alessandra Mallozzi Menegatti, Claudia Parisi, Elisa Misurati, Ruana Tiseo, Massimo Gallerani, Raffaella Salmi, Eduardo Bossone
Roberto Manfredini, Fabio Fabbian, Alfredo De Giorgi, Marco Pala, Alessandra Mallozzi Menegatti, Claudia Parisi, Elisa Misurati, Ruana Tiseo, Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, 44124 Cona, Ferrara, Italy
Massimo Gallerani, 1st Internal Medicine Unit, Azienda Ospedaliera-Universitaria of Ferrara, 44124 Cona, Ferrara, Italy
Raffaella Salmi, 2nd Internal Medicine Unit, Azienda Ospedaliera-Universitaria of Ferrara, 44124 Cona, Ferrara, Italy
Eduardo Bossone, Cardiology Unit, Azienda Ospedaliera-Universitaria of Salerno, 84131 Salerno, Italy
Author contributions: Manfredini R and Bossone E equally contributed to the work; Manfredini R, Fabbian F, Gallerani M, Salmi R, Bossone E designed the research; De Giorgi A, Pala M, Mallozzi Menegatti A, Parisi C, Misurati E, Tiseo R searched the available literature, found the articles, and performed the research; Manfredini R, Fabbian F, De Giorgi A, Pala M, Mallozzi Menegatti A, Parisi C, Misurati E, Tiseo R analyzed the data; Manfredini R, Fabbian F, Bossone E, Gallerani M wrote the paper; Manfredini R, Fabbian F, De Giorgi A, Pala M, Mallozzi Menegatti A, Parisi C, Misurati E, Tiseo R, Gallerani M, Salmi R, Bossone E revised critically the manuscript for intellectual and conceptual content, and approved the final version; Manfredini R collected funds.
Supported by A scientific grant (FAR–Fondo Ateneo Ricerca) from the University of Ferrara, Italy (in part)
Correspondence to: Roberto Manfredini, MD, Clinica Medica, Azienda Ospedaliera-Universitaria of Ferrara, Via Aldo Moro 8, 44124 Cona, Ferrara, Italy. roberto.manfredini@unife.it
Telephone: +39-0532-237166 Fax: +39-0532-236816
Received: December 21, 2013
Revised: March 11, 2014
Accepted: April 17, 2014
Published online: May 26, 2014
AIM: To investigate the possible association between Tako-tsubo cardiomyopathy (TTC)-a reversible clinical condition mimicking an acute myocardial infarction characterized by multifactorial pathophysiologic mechanisms- and respiratory system diseases.
METHODS: We systematically searched PubMed and EMBASE medical information sources, to identify the different triggering causes, limiting our search to articles in English. The search keywords were: “tako-tsubo cardiomyopathy”, “takotsubo”, “takotsubo cardiomyopathy”, “broken heart syndrome”, “stress-induced cardiomyopathy”, “apical ballooning syndrome”, and “ampulla cardiomyopathy in combination with respiratory diseases, lung, pulmonary disease. For each kind of disease, we registered: author, year and country of study, patient sex, age, concurring situation, and outcome.
RESULTS: Out of a total of 1725 articles found, we selected 37 papers reporting a total of 38 patients. As expected, most patients were women (81.6%), mean age was 65 ± 10 years. Outcome was favorable in 100% of cases, and all the patients have been discharged uneventfully in a few days.
CONCLUSION: An association between respiratory diseases and TTC is likely to exist. Patients with severe respiratory diseases, due to the high dosages of β2-agonists used or to the need of invasive procedures, are highly exposed to the risk of developing TTC.
Core tip: This is the first study evaluating the association between respiratory diseases and Tako-Tsubo cardiomyopathy (TTC). Patients with severe respiratory diseases, due to the high dosages of β2-agonists used or to the need of invasive procedures, are highly exposed to the risk of developing TTC. Thus, in these patients a certain caution should maintained, along with a special alertness in suspecting and recognizing this particular disease.
