Cardiac biomarkers for diagnosing Takotsubo syndrome

作者：Victor Schweiger, Davide Di Vece, Victoria L. Cammann, Iva Koleva, Michael Würdinger, Thomas Gilhofer, Katja Rajman, Konrad A. Szawan, David Niederseer, Rodolfo Citro, Carmine Vecchione, Eduardo Bossone, Sebastiano Gili, Michael Neuhaus, Jennifer Franke, Benjamin Meder, Miłosz Jaguszewski, Michel Noutsias, Maike Knorr, Thomas Jansen, Fabrizio D’Ascenzo, Francesco Bruno, Ovidio De Filippo, Giulio Stefanini, Gianluca Campo, Wojciech Wańha, Sergio Raposeiras‐Roubín, Wolfgang Dichtl, Dirk von Lewinski, Christof Burgdorf, Behrouz Kherad, Carsten Tschöpe, Annahita Sarcon, Jerold S. Shinbane, Lawrence Rajan, Guido Michels, Roman Pfister, Alessandro Cuneo, Claudius Jacobshagen, Mahir Karakas, Wolfgang Köenig, Alexander Pott, Philippe Meyer, Marco Roffi, Adrian Banning, Mathias Wolfrum, Florim Cuculi, Richard Kobza, Thomas Fischer, Tuija Vasankari, Juhani Airaksinen, L. Christian Napp, Rafał Dworakowski, Philip MacCarthy, Christoph Kaiser, Stefan Osswald, Leonarda Galiuto, Christina Chan, Paul Bridgman, Daniel Beug, Clément Delmas, Olivier Lairez, Ekaterina Gilyarova, Alexandra Shilova, Mikhail Gilyarov, Ibrahim El‐Battrawy, İbrahim Akın, Karolína Poledníková, Petr Toušek, David E. Winchester, Michael Massoomi, Jan Gałuszka, Christian Ukena, Gregor Poglajen, Pedro Carrilho‐Ferreira, Christian Hauck, Carla Paolini, Claudio Bilato, Yoshio Kobayashi, Ken Kato, Iwao Ishibashi, Toshiharu Himi, Jehangir Din, Ali Saad Al‐Shammari, Abhiram Prasad, Charanjit S. Rihal, Kan Liu, P. Christian Schulze, Matteo Bianco, Lucas Jörg, Hans Rickli, Gonçalo Pestana, Thanh H. Nguyen, Michael Böhm, Lars S. Maier, Fausto J. Pinto, Petr Widimský, Stephan B. Felix, Ruediger C. Braun‐Dullaeus, Wolfgang Rottbauer, Gerd Hasenfuß, Burkert Pieske, Heribert Schunkert, Monika Budnik, Grzegorz Opolski, Holger Thiele, Johann Bauersachs, John D. Horowitz, Carlo Di Mario, William Kong, Mayank Dalakoti, Yoichi Imori, Thomas Münzel, Jeroen J. Bax, Thomas F. Lüscher, Filippo Crea, Frank Ruschitzka, Jelena R. Ghadri, Christian Templin · 发表于：European Heart Journal · 年份：2024 · DOI：10.1093/eurheartj/ehae231 · 被引用次数：14 · 研究领域：Takotsubo Cardiomyopathy and Associated Phenomena、Cardiac Imaging and Diagnostics、Cardiac Structural Anomalies and Repair

Takotsubo syndrome (TTS) is characterized by transient left ventricular wall motion anomalies associated with coronary microvascular dysfunction in the absence of culprit lesions of epicardial coronary arteries.1 The clinical presentation of TTS resembles that of typical acute coronary syndrome (ACS).2 Despite coronary angiography being the gold standard for TTS diagnosis, its limitations and unessential role in disease management necessitate non-invasive diagnostic methods.2 Patients with TTS exhibit distinctive patterns of classic cardiac biomarkers compared to patients with ACS. Specifically, TTS is associated with higher brain natriuretic peptide (BNP) levels attributed to heightened filling pressures, and conversely, lower levels of troponin or creatine kinase (CK), as a consequence of distinct pathophysiological mechanisms.2,3 These variations in biomarker levels have been proposed as valuable indicators in differentiating these two entities from another.4 However, although previously proposed ratios of classic cardiac biomarkers exhibit promise in distinguishing TTS from ACS, their applicability was restricted by small sample sizes and a lack of validation.5–9 Thus, the present study aims to validate these ratios in the largest database dedicated to TTS worldwide, the International Takotsubo (InterTAK) Registry.1