title: Stress cardiomyopathy (tako-tsubo) triggered by nervous system diseases: a systematic review of the reported cases.
abstract: BACKGROUND
  It is not clarified whether the transient, regional left ventricular dysfunction (TRLVD) associated with several neurological disorders shares the same pathophysiology with the classical tako-tsubo cardiomyopathy occurring without overt neurological disease, and whether it is appropriate to include these patients in a single stress cardiomyopathy (SCM) condition.
  
  
  METHODS
  In February 2012, we systematically explored major electronic medical information sources to identify cases of TRLVD triggered by neurological disorders.
  
  
  RESULTS
  The 81 selected papers reported a total of 124 patients, suffering from neurological disorders, in whom TRLVD occurred: 117 with central nervous system diseases, 6 with peripheral nervous system diseases and 1 with both systems involved. Most patients were females (n=102), mean age was 63 ± 15 years, and the majority presented with an apex-involving pattern. The most common disease described was subarachnoid hemorrhage (n=52), followed by stroke/transient ischemic attack (n=24), and seizures (n=18). TRLVD in neurological patients was often associated with need of inotropic support, orotracheal intubation, cerebrovascular spasm and delayed surgery.
  
  
  CONCLUSIONS
  TRLVD is a complication of neurological diseases, in particular in female patients in post-menopausal phase. The predilection for neurological damage at or close to the insular cortex highlights the pivotal role of sympathetic over-activation. Many other similarities with tako-tsubo support the inclusion in a single SCM category.
authors: Cardiovascular and Neurological Department, Ospedale San Donato, Arezzo, Italy. italo.porto@gmail.com
authors: Italo
authors: I
authors: Porto
authors: Roberta
authors: R
authors: Della Bona
authors: Andrea
authors: A
authors: Leo
authors: Riccardo
authors: R
authors: Proietti
authors: Maurizio
authors: M
authors: Pieroni
authors: Carlo
authors: C
authors: Caltagirone
authors: Gianfranco
authors: G
authors: Spalletta
authors: Leonardo
authors: L
authors: Bolognese
authors: Luca
authors: L
authors: Cravello
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D057286:Electronic Health Records / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications* / Q000175:diagnosis* / Q000523:psychology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000209:etiology* / Q000523:psychology
keywords: Nervous system disease; Stress cardiomyopathy; Tako-tsubo