title: The Sympathetic Nervous System in the Pathogenesis of Takotsubo Syndrome.
abstract: Takotsubo syndrome is a unique clinical condition of acute heart failure and reversible left ventricular dysfunction frequently precipitated by sudden emotional or physical stress. There is growing evidence that exaggerated sympathetic stimulation is central to the pathogenesis of this syndrome. Precisely how catecholamines mediate myocardial stunning in takotsubo syndrome remains incompletely understood; but possible mechanisms include epicardial spasm, microvascular dysfunction, direct adrenergic-receptor-mediated myocyte injury, and systemic vascular effects that alter ventricular-arterial coupling. Risk factors that increase sympathetic tone and/or catecholamine sensitivity may render individuals particularly susceptible to takotsubo syndrome during episodes of acute stress.
authors.affiliation: Division of Cardiology, The Johns Hopkins University School of Medicine, 7125 Zayed Tower, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: iwittste@jhmi.edu.
authors.forename: Ilan S
authors.initials: IS
authors.lastname: Wittstein
mesh_terms: D000818:Animals; D002395:Catecholamines / Q000378:metabolism; D006801:Humans; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D054549:Takotsubo Cardiomyopathy / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology
chemical_list: D002395:Catecholamines
keywords: Catecholamines; Stress cardiomyopathy; Sympathetic nervous system; Takotsubo syndrome; Ventricular ballooning