Abstract
Takotsubo syndrome (TTS) presents as an acute coronary syndrome characterized by severe left ventricular (LV) dysfunction and non-obstructive coronary artery disease that typically shows spontaneous recovery within days or weeks. The mechanisms behind TTS are mainly related to beta-adrenergic overstimulation and acute endogenous catecholamine surge, both of which could increase oxidative status that may induce further deterioration of cardiac function. Although several studies reported evidence of inflammation and oxidative stress overload in myocardial tissue of TTS models, systemic biochemical evidence of augmented oxidant activity in patients with TTS is lacking. In this study, serum samples of ten TTS patients and ten controls have been analyzed using 1H-NMR spectroscopy. The results of this pilot study show a marked alteration in the systemic metabolic profile of TTS patients, mainly characterized by significant elevation of ketone bodies, 2-hydroxybutyrate, acetyl-L-carnitine, and glutamate levels, in contrast with a decrease of several amino acid levels. The overall metabolic fingerprint reflects a systemic response to oxidative stress caused by the stressor that triggered the syndrome’s onset.
Highlights
Few diseases show a more creative name and a more emotionally related origin than the Takotsubo syndrome (TTS), a disorder that differentially affects women
Serum Metabolic Profile Differentiate Takotsubo from Control Subjects
This hypothesis fits with the changes in the serum metabolic profile of TTS patients observed in our study, which we have interpreted as a response to this redox unbalance (Scheme 1)
Summary
Few diseases show a more creative name and a more emotionally related origin than the Takotsubo syndrome (TTS), a disorder that differentially affects women They account for 80% to 100% of cases, with a mean age at diagnosis of 61 to 76 years [1]. TTS is often precipitated by major emotional/physical stress such as grief, fear/panic, anger, anxiety, embarrassment, or even positive emotions. A striking increase in apparently MI episodes was noticed in the past, coinciding with natural disasters such as earthquakes [4] or during major sporting events [5] It was not until more recent times that it was possible to understand that the boosts were correlated to the underlying stress [6]
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