A mid‐ventricular variant of Takotsubo syndrome: was it triggered by insular cortex damage?. (3rd May 2021)

• Record Type: Journal Article
• Authors: Osawa, Ayano; Nagai, Michiaki; Dote, Keigo; Kato, Masaya; Oda, Noboru; Kunita, Eiji; Kagawa, Eisuke; Yamane, Aya; Kobatake, Hiroshi; Shiota, Haruko; Ishibashi, Naoki; Takahashi, Kazuki; Förster, Carola Y.
• Is Part Of: ESC heart failure. Volume 8:Number 4(2021)
• Page Start: 3408
• Page End: 3412
• Publication Date: 2021-05-03
• Subjects: Takotsubo syndrome -- Mid‐ventricular variant -- Central autonomic network -- Insular cortex -- Ischaemic stroke -- Laterality; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.13397
• Languages: English
• ISSNs: 2055-5822

Abstract

Abstract: Takotsubo syndrome (TTS) is a transient cardiomyopathy that is often associated with cerebrovascular diseases. Earlier studies have supported the concept that the cardiovascular system is regulated by a central autonomic network (CAN) consisting of the insular cortex (IC), anterior cingulate gyrus and amygdala. We report the case of a 79‐year‐old female diagnosed with a mid‐ventricular variant of TTS concomitant with right IC ischaemic stroke. After 12 h of hospitalization, she experienced a sudden collapse. Rapid cardiopulmonary resuscitation resulted in a return of spontaneous circulation. Subsequent left ventriculography revealed akinesis in the mid‐portion of the left ventricle with vigorous contraction of the basal and apex segment. Two weeks after admission, cardiac ultrasound showed improved left ventricular contraction. Right IC ischaemia in this patient might have been associated with a dysregulation of the CAN and subsequent increased sympathetic nervous system activity that triggered TTS.