Stress (Takotsubo) Cardiomyopathy: A Crosstalk between the Brain and Heart

Wei-Ting Chang, M.D. (Editor)
Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan
Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan

Wen-Lieng Yu (Editor)
Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan

Chon-Seng Hong, M.D. (Editor)
Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan

Chia-Te Liao, M.D. (Editor)
Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan

Jinn-Rung Kuo, M.D., Ph.D. (Editor)
Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan

Yen-Wen Liu (Editor)
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan

Series: Cardiology Research and Clinical Developments
BISAC: MED010000

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Stress cardiomyopathy, also called Takotsubo cardiomyopathy or apical ballooning syndrome, is defined as acute left ventricular dysfunction associated with high stimulation of endogenous or exogenous catecholamine in a critically ill individual. The detailed mechanisms underlying the association between this autonomic storm and myocardial toxicity are comprehensively discussed in this book. According to the diagnostic criteria released by the American Heart Association, the diagnosis of this reversible cardiomyopathy requires: 1) Transient left ventricular wall motion abnormalities involving the apical and/or midventricular myocardial segments with wall motion abnormalities extending beyond a single epicardial coronary artery distribution; 2) the absence of obstructive epicardial coronary artery disease that could be responsible for the observed wall motion abnormality; 3) ECG abnormalities, such as transient ST-segment elevation and/or diffused T wave inversion associated with a slight troponin elevation; and 4) the lack of proven pheochromocytoma and myocarditis.
However, the detailed mechanisms through which the autonomic nervous systems regulate the heart and the manner in which their impairment caused adverse effects on cardiovascular function have not yet been well described. Also, increasing evidences indicated that the long term cardiovascular or neurologic impact of stress cardiomyopathy may not be as benign and we thought. Also, there is limited evidence regarding the management. At least recent clinical researches explored whether specific factors explain specific patient susceptibilities to the disease and should be directed towards early identification and stratification at risk. The purpose of this book is to provide an up-to-date review of the clinical presentation of stress cardiomyopathy, discuss possible causal mechanisms, and highlight the recent development of managements.
This issue of stress cardiomyopathy comprehensively discussed the crosstalk between the brain and the heart. Experts review the most updated literature regarding clinical profile, imaging modalities, management and infectious or neurologic stress induced cardiomyopathy. The latest information will help medical practitioners in the diagnosis and management of this condition.

Preface

Chapter 1. Clinical Definition, Nature Course and Epidemiology of Stress Cardiomyopathy
(Wei-Ting Chang, MD, and Chon-Seng Hong, MD, Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan, and others)

Chapter 2. The Pathophysiology of Stress Cardiomyopathy
(Wei-Ting Chang, MD, Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan, and others)

Chapter 3. Imaging Diagnosis of Stress Cardiomyopathy
(Yen-Wen Liu, MD, PhD, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan)

Chapter 4. Infectious Etiologies of Stress Cardiomyopathy
(Wen-Liang Yu, M.D., Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan City, Taiwan, and others)

Chapter 5. Neurogenic Stress Cardiomyopathy
(Jinn-Rung.Kuo, MD, PhD, Department of Neurosurgery, Chi-Mei Medical Center, Tainan, Taiwan)

Chapter 6. The Updated Management and Outcomes of Stress Cardiomyopathy
(Chia-Te Liao, MD, Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan)

Index

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