Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study
Takotsubo syndrome (TTS) is an acute cardiac syndrome characterized by regional left ventricular dysfunction with a peculiar circumferential pattern, which typically results in apical ballooning. Evidence indicates a pivotal role of catecholamines in TTS, and researchers have discussed multiple hypo...
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Frontiers Media S.A.
2018-12-01
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Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2018.01099/full |
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doaj-43f4faa9deb84dc18a60d5fcb516d943 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yuishin Izumi Ryosuke Miyamoto Koji Fujita Yuki Yamamoto Hirotsugu Yamada Tomoyasu Matsubara Yuki Unai Ai Tsukamoto Naoko Takamatsu Hiroyuki Nodera Shinya Hayashi Masaya Oda Atsuko Mori Yoshihiko Nishida Shunsuke Watanabe Hirohisa Ogawa Hisanori Uehara Shigeo Murayama Masataka Sata Ryuji Kaji |
spellingShingle |
Yuishin Izumi Ryosuke Miyamoto Koji Fujita Yuki Yamamoto Hirotsugu Yamada Tomoyasu Matsubara Yuki Unai Ai Tsukamoto Naoko Takamatsu Hiroyuki Nodera Shinya Hayashi Masaya Oda Atsuko Mori Yoshihiko Nishida Shunsuke Watanabe Hirohisa Ogawa Hisanori Uehara Shigeo Murayama Masataka Sata Ryuji Kaji Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study Frontiers in Neurology takotsubo syndrome amyotrophic lateral sclerosis synucleinopathy Parkinson's disease dementia with Lewy bodies multiple system atrophy |
author_facet |
Yuishin Izumi Ryosuke Miyamoto Koji Fujita Yuki Yamamoto Hirotsugu Yamada Tomoyasu Matsubara Yuki Unai Ai Tsukamoto Naoko Takamatsu Hiroyuki Nodera Shinya Hayashi Masaya Oda Atsuko Mori Yoshihiko Nishida Shunsuke Watanabe Hirohisa Ogawa Hisanori Uehara Shigeo Murayama Masataka Sata Ryuji Kaji |
author_sort |
Yuishin Izumi |
title |
Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study |
title_short |
Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study |
title_full |
Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study |
title_fullStr |
Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study |
title_full_unstemmed |
Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort Study |
title_sort |
distinct incidence of takotsubo syndrome between amyotrophic lateral sclerosis and synucleinopathies: a cohort study |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2018-12-01 |
description |
Takotsubo syndrome (TTS) is an acute cardiac syndrome characterized by regional left ventricular dysfunction with a peculiar circumferential pattern, which typically results in apical ballooning. Evidence indicates a pivotal role of catecholamines in TTS, and researchers have discussed multiple hypotheses on the etiology, including multivessel coronary spasm, myocardial stunning, excessive transient ventricular afterload, and cardiac sympathetic overactivity with local noradrenaline spillover. Although central nervous system disorders, such as stroke and epilepsy, are known to trigger TTS, the incidence and clinical features of TTS in neurodegenerative disorders are poorly understood. Here, we retrospectively examined TTS cases in a single-center cohort composed of 250 patients with amyotrophic lateral sclerosis (ALS) and 870 patients with synucleinopathies [582 patients with Parkinson's disease (PD), 125 patients with dementia with Lewy bodies (DLB), and 163 patients with multiple system atrophy (MSA)] and identified 4 (1.6%, including 2 women) cases with ALS and no cases with synucleinopathies. Two ALS patients underwent autopsy and the pathological findings were compatible with the chronological changes identified in catecholamine-induced cardiomyopathy. A literature review identified 16 TTS cases with ALS, 1 case each with PD and DLB, and no cases with MSA. When current and previous TTS cases with ALS were concatenated: 55% (11/20) were female; 35% (7/20) had a bulbar-onset and 45% (9/20) had a limb-onset; the mean age of TTS onset was 63.3 ± 9.0 years and the mean interval time from ALS onset to TTS development was 4.9 ± 3.0 years; no (0/16) patients developed TTS within 12 months after ALS onset; 50% (10/20) underwent artificial ventilations; the mortality was 17% (3/18); and most cases had precipitating factors, and TTS development was associated with gastrostomy, tracheostomy, or infections in 45% (9/20) of the patients. This study demonstrated that ALS is a considerable predisposing factor of TTS and that synucleinopathies rarely cause TTS. The distinct TTS incidence between ALS and synucleinopathies may be due to cardiac sympathetic overactivity in ALS and may also be affected by cardiac sympathetic denervation in synucleinopathies. Moreover, the etiology of TTS in ALS may be reasonably explained by the two-hit theory. |
topic |
takotsubo syndrome amyotrophic lateral sclerosis synucleinopathy Parkinson's disease dementia with Lewy bodies multiple system atrophy |
url |
https://www.frontiersin.org/article/10.3389/fneur.2018.01099/full |
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doaj-43f4faa9deb84dc18a60d5fcb516d9432020-11-25T00:13:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-12-01910.3389/fneur.2018.01099426439Distinct Incidence of Takotsubo Syndrome Between Amyotrophic Lateral Sclerosis and Synucleinopathies: A Cohort StudyYuishin Izumi0Ryosuke Miyamoto1Koji Fujita2Yuki Yamamoto3Hirotsugu Yamada4Tomoyasu Matsubara5Yuki Unai6Ai Tsukamoto7Naoko Takamatsu8Hiroyuki Nodera9Shinya Hayashi10Masaya Oda11Atsuko Mori12Yoshihiko Nishida13Shunsuke Watanabe14Hirohisa Ogawa15Hisanori Uehara16Shigeo Murayama17Masataka Sata18Ryuji Kaji19Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, JapanDepartment of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Neurology, Tokushima Hospital, Yoshinogawa, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Internal Medicine, Kaminaka Hospital, Naka, JapanDepartment of Neurology, Mifukai Vihara Hananosato Hospital, Miyoshi, JapanDepartment of Neurology, Itsuki Hospital, Tokushima, JapanDepartment of Neurology, Itsuki Hospital, Tokushima, JapanDepartment of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Pathology and Laboratory Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDivision of Pathology, Tokushima University Hospital, Tokushima, JapanDepartment of Neuropathology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan0Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanDepartment of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, JapanTakotsubo syndrome (TTS) is an acute cardiac syndrome characterized by regional left ventricular dysfunction with a peculiar circumferential pattern, which typically results in apical ballooning. Evidence indicates a pivotal role of catecholamines in TTS, and researchers have discussed multiple hypotheses on the etiology, including multivessel coronary spasm, myocardial stunning, excessive transient ventricular afterload, and cardiac sympathetic overactivity with local noradrenaline spillover. Although central nervous system disorders, such as stroke and epilepsy, are known to trigger TTS, the incidence and clinical features of TTS in neurodegenerative disorders are poorly understood. Here, we retrospectively examined TTS cases in a single-center cohort composed of 250 patients with amyotrophic lateral sclerosis (ALS) and 870 patients with synucleinopathies [582 patients with Parkinson's disease (PD), 125 patients with dementia with Lewy bodies (DLB), and 163 patients with multiple system atrophy (MSA)] and identified 4 (1.6%, including 2 women) cases with ALS and no cases with synucleinopathies. Two ALS patients underwent autopsy and the pathological findings were compatible with the chronological changes identified in catecholamine-induced cardiomyopathy. A literature review identified 16 TTS cases with ALS, 1 case each with PD and DLB, and no cases with MSA. When current and previous TTS cases with ALS were concatenated: 55% (11/20) were female; 35% (7/20) had a bulbar-onset and 45% (9/20) had a limb-onset; the mean age of TTS onset was 63.3 ± 9.0 years and the mean interval time from ALS onset to TTS development was 4.9 ± 3.0 years; no (0/16) patients developed TTS within 12 months after ALS onset; 50% (10/20) underwent artificial ventilations; the mortality was 17% (3/18); and most cases had precipitating factors, and TTS development was associated with gastrostomy, tracheostomy, or infections in 45% (9/20) of the patients. This study demonstrated that ALS is a considerable predisposing factor of TTS and that synucleinopathies rarely cause TTS. The distinct TTS incidence between ALS and synucleinopathies may be due to cardiac sympathetic overactivity in ALS and may also be affected by cardiac sympathetic denervation in synucleinopathies. Moreover, the etiology of TTS in ALS may be reasonably explained by the two-hit theory.https://www.frontiersin.org/article/10.3389/fneur.2018.01099/fulltakotsubo syndromeamyotrophic lateral sclerosissynucleinopathyParkinson's diseasedementia with Lewy bodiesmultiple system atrophy |