Takotsubo syndrome in the context of pre-existing non-ischemic cardiomyopathy: mechanistic and clinical implications

ÖZKAN U., YALTA A. K.

Postgraduate Medicine, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1080/00325481.2026.2658365
  • Dergi Adı: Postgraduate Medicine
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, Educational research abstracts (ERA), EMBASE
  • Anahtar Kelimeler: Catecholamine surge, inflammation, myocardial stunning, non-ischemic cardiomyopathy, Takotsubo syndrome
  • Trakya Üniversitesi Adresli: Evet

Özet

Takotsubo syndrome (TTS), a transient left ventricular (LV) dysfunction typically precipitated by acute emotional or physical stress, is classically observed in individuals with structurally normal hearts. However, its occurrence in patients with established non-ischemic cardiomyopathy (NICMP) represents a striking clinical paradox that challenges our current understanding of both disease entities. This comprehensive review examines the complex pathophysiological mechanisms underlying this phenomenon, with particular emphasis on supraphysiological catecholamine surge and biased β-adrenergic receptor signaling, inflammatory-mediated sensitization, intrinsic mitochondrial dysfunction and mechanically-induced cytokine amplification.