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Advisor(s)
Abstract(s)
A prevalência de Miocardiopatia de Takotsubo é estimada em 1-3% de todos os pacientes com suspeita de síndrome coronário agudo. Enquanto o processo fisiopatológico permanece ainda uma incerteza, pacientes com Miocardiopatia de Takotsubo e pacientes com síndroma coronário agudo partilham os mesmos factores de risco cardiovascular, embora os achados angiográfios mostrem que ruptura de placas de ateroma coronárias não explica a fisiopatologia de Miocardiopatia de Takotsubo.
A maioria dos estudos aponta a hipótese de disfunção miocárdica mediada por catecolaminas como a via final na patogénese de Miocardiopatia de Takotsubo. Este mecanismo sugere que um papel importante é desempenhado pela activação do sistema nervoso simpático, a qual seria desencadeada por um evento stressante. Não obstante, embora uma situação de stresse intenso esteja na origem de Miocardiopatia de Takotsubo, existe escassa evidência sobre os factores que a originam.
É conhecida a associação entre sintomas depressivos e o aumento do risco cardiovascular. Estudos retrospectivos recentes têm sugerido que a existência de doença psiquiátrica e características pré-morbidas pode ser um importante factor predisponente de Miocardiopatia de Takotsubo. Estas evidências sugerem a influência de factores psicossociais na incidência de Miocardiopatia de Takotsubo.
Esta revisão de literatura tem como objectivo reunir a evidência científica disponível que permita responder, pelo menos em parte, à questão de quais os aspectos psicossociais e qual o seu papel na patogénese, prevalência e prognóstico de Miocardiopatia de Takotsubo.
The prevalence of Takotsubo Cardiomyopathy accounts for 1-3% of all patiens suspected to have acute coronary syndrome. Whereas the pathophysiology remains uncertain, both pacients with Takotsubo Cardiomyopathy and acute coronary sindrome share commun cardiovascular risk factors. Although, angiographic findings depict that atheroma embolic causes do not explain its pathophysiologic mechanisms. Most cientific evidence singles out the chatecholamine-mediated hypothesis as the primal mean of myocardial stunning in Takotsubo Cardiomyopathy. This mechanism points sympathetic nervous system activation as a key factor, which would be triggered by sudden stress. Neverthless, as much as a stressful event is frequently the precipitator of Takotsubo Cardiomyopathy, little is know about the factors preceding it. Although, i tis known the association between depressive symptoms and incrise of cardiovascular mortality risk. Recent retrospective studies have suggested that psychiatric disease and pré-morbid characteristcs could play an important role in predisposing risk factors for Takotsubo Cardiomyopathy. This findings suggests plausible influence of psychossocial factors on Takotsubo Cardiomyopathy. This literature review has the purpose to gather the cientific available evidence that would allow to answer, at least partially, to the question of which psychossocial factors and the role they play in pathophysiology, prevalence and prognosis of Takotsubo Cardiomyopathy.
The prevalence of Takotsubo Cardiomyopathy accounts for 1-3% of all patiens suspected to have acute coronary syndrome. Whereas the pathophysiology remains uncertain, both pacients with Takotsubo Cardiomyopathy and acute coronary sindrome share commun cardiovascular risk factors. Although, angiographic findings depict that atheroma embolic causes do not explain its pathophysiologic mechanisms. Most cientific evidence singles out the chatecholamine-mediated hypothesis as the primal mean of myocardial stunning in Takotsubo Cardiomyopathy. This mechanism points sympathetic nervous system activation as a key factor, which would be triggered by sudden stress. Neverthless, as much as a stressful event is frequently the precipitator of Takotsubo Cardiomyopathy, little is know about the factors preceding it. Although, i tis known the association between depressive symptoms and incrise of cardiovascular mortality risk. Recent retrospective studies have suggested that psychiatric disease and pré-morbid characteristcs could play an important role in predisposing risk factors for Takotsubo Cardiomyopathy. This findings suggests plausible influence of psychossocial factors on Takotsubo Cardiomyopathy. This literature review has the purpose to gather the cientific available evidence that would allow to answer, at least partially, to the question of which psychossocial factors and the role they play in pathophysiology, prevalence and prognosis of Takotsubo Cardiomyopathy.
Description
Keywords
Aspectos Psicossociais Factores Predisponentes Insuficiência Cardíaca. Miocardiopatia de Takotsubo