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Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis

Takotsubo syndrome (TTS) represents a form of acute heart failure featured by reversible left ventricular systolic dysfunction. The management during the acute phase is mainly performed with supportive pharmacological (diuretics, ACE-inhibitors/angiotensin-receptor blockers (ARBs), anticoagulants, a...

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Autores principales: Santoro, Francesco, Mallardi, Adriana, Leopizzi, Alessandra, Vitale, Enrica, Rawish, Elias, Stiermaier, Thomas, Eitel, Ingo, Brunetti, Natale D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866173/
https://www.ncbi.nlm.nih.gov/pubmed/33530545
http://dx.doi.org/10.3390/jcm10030468
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author Santoro, Francesco
Mallardi, Adriana
Leopizzi, Alessandra
Vitale, Enrica
Rawish, Elias
Stiermaier, Thomas
Eitel, Ingo
Brunetti, Natale D.
author_facet Santoro, Francesco
Mallardi, Adriana
Leopizzi, Alessandra
Vitale, Enrica
Rawish, Elias
Stiermaier, Thomas
Eitel, Ingo
Brunetti, Natale D.
author_sort Santoro, Francesco
collection PubMed
description Takotsubo syndrome (TTS) represents a form of acute heart failure featured by reversible left ventricular systolic dysfunction. The management during the acute phase is mainly performed with supportive pharmacological (diuretics, ACE-inhibitors/angiotensin-receptor blockers (ARBs), anticoagulants, antiarrhythmics, non-catecholamine inotropics (levosimendan), and non-pharmacological (mechanical circulatory and respiratory support) therapy, due to the wide clinical presentation and course of the disease. However, there is a gap in evidence and there are no randomized and adequately powered studies on clinical effectiveness of therapeutic approaches. Some evidence supports the use ACE-inhibitors/ARBs at long-term. A tailored approach based on cardiovascular and non-cardiovascular risk factors is strongly suggested for long-term management. The urgent need for evidence-based treatment approaches is also reflected by the prognosis following TTS. The acute phase of the disease can be accompanied by various cardiovascular complications. In addition, long term outcome of TTS patients is also related to non-cardiovascular comorbidities. Physical triggers such as hypoxia and acute neurological disorders in TTS are associated with a poor outcome.
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spelling pubmed-78661732021-02-07 Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis Santoro, Francesco Mallardi, Adriana Leopizzi, Alessandra Vitale, Enrica Rawish, Elias Stiermaier, Thomas Eitel, Ingo Brunetti, Natale D. J Clin Med Review Takotsubo syndrome (TTS) represents a form of acute heart failure featured by reversible left ventricular systolic dysfunction. The management during the acute phase is mainly performed with supportive pharmacological (diuretics, ACE-inhibitors/angiotensin-receptor blockers (ARBs), anticoagulants, antiarrhythmics, non-catecholamine inotropics (levosimendan), and non-pharmacological (mechanical circulatory and respiratory support) therapy, due to the wide clinical presentation and course of the disease. However, there is a gap in evidence and there are no randomized and adequately powered studies on clinical effectiveness of therapeutic approaches. Some evidence supports the use ACE-inhibitors/ARBs at long-term. A tailored approach based on cardiovascular and non-cardiovascular risk factors is strongly suggested for long-term management. The urgent need for evidence-based treatment approaches is also reflected by the prognosis following TTS. The acute phase of the disease can be accompanied by various cardiovascular complications. In addition, long term outcome of TTS patients is also related to non-cardiovascular comorbidities. Physical triggers such as hypoxia and acute neurological disorders in TTS are associated with a poor outcome. MDPI 2021-01-26 /pmc/articles/PMC7866173/ /pubmed/33530545 http://dx.doi.org/10.3390/jcm10030468 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Santoro, Francesco
Mallardi, Adriana
Leopizzi, Alessandra
Vitale, Enrica
Rawish, Elias
Stiermaier, Thomas
Eitel, Ingo
Brunetti, Natale D.
Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title_full Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title_fullStr Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title_full_unstemmed Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title_short Current Knowledge and Future Challenges in Takotsubo Syndrome: Part 2—Treatment and Prognosis
title_sort current knowledge and future challenges in takotsubo syndrome: part 2—treatment and prognosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866173/
https://www.ncbi.nlm.nih.gov/pubmed/33530545
http://dx.doi.org/10.3390/jcm10030468
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