title: Therapy of stress (takotsubo) cardiomyopathy: present shortcomings and future perspectives.
abstract: Several therapeutic options are available for the treatment of the acute phase of stress cardiomyopathy, pharmacological (β-blockers, diuretics, anticoagulants, antiarrhythmics, noncatecholamine inotropics [levosimendan]), and nonpharmacological (intra-aortic balloon pumping, extracorporeal membrane oxygenation), according to the wide possible clinical presentation and course of the disease. However, there is a gap in evidence, and very few data come from randomized and adequately powered studies. Some evidence supports the use of β-blockers, in particular with a short half-life, in the case of left ventricular outflow tract obstruction, and angiotensin-converting enzyme inhibitors in secondary prevention. Future perspectives include the study of genetic basis of stress cardiomyopathy, role of miRNA and neurovegetative modulation. Randomized studies, however, are surely warranted.
authors.affiliation: Cardiology Department, University of Foggia, Italy.
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
authors.affiliation: Cardiology Department, University of Foggia, Italy.|Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.affiliation: Ospedale San Paolo, Bari, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: De Gennaro
authors.affiliation: Cardiologia Universitaria, Ospedali Riuniti, Foggia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Correale
authors.affiliation: Asklepios Klinik St Georg, Hamburg, Germany.
authors.forename: Hayashi
authors.initials: H
authors.lastname: Kentaro
authors.affiliation: Cardiology Department, University of Foggia, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gaglione
authors.affiliation: Cardiology Department, University of Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015199:Extracorporeal Membrane Oxygenation; D005544:Forecasting; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D055502:Secondary Prevention; D054549:Takotsubo Cardiomyopathy / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: drug; review; stress cardiomyopathy; takotsubo cardiomyopathy; therapy