摘要
应激性心肌病(TTS)是一种急性且大部分可逆的心肌病。虽然儿茶酚胺升高与TTS有关,但详细的致病机制尚不完全清楚。根据左室壁运动异常的分布,临床分成不同亚型。最终诊断需要心脏血管造影、超声心动图以及心脏磁共振。治疗建议多来自于观察性研究,而非多中心随机对照研究。对重症患者,机械循环辅助是必要的支持措施,同时应避免使用儿茶酚胺和正性肌力药物。本文旨在综述TTS的发病机制、临床表现、诊断、治疗及预后,提出儿童TTS尚待解决的问题。
Takotsubo syndrome(TTS)is an acute and mostly reversible cardiomyopathy that mimics an acute coronary syndrome with systolic dysfunction of left ventricular.Although supraphysiological epinephrine levels have been associated with TTS,the detailed pathophysiology is incompletely understood.According to the distribution of left ventricular wall motion abnormalities,various morphological subtypes have been identified.The ultimate diagnosis depends on cardiac imaging with left ventricular angiography during acute heart catheterization,as well as echocardiography and cardiac magnetic resonance.Management is based on observational data,while randomized multicenter studies are still lacking.Mechanical circulatory support is an emerging strategy for patients with TTS and shock,in order to avoid catecholamines and inotropes in particular.This review provides a general overview of TTS.However,the demographic characteristics,diagnosis,treatment and prognosis of TTS have not been well studied in children.
作者
张建
任宏
Zhang Jian;Ren Hong(Department of Pediatric Intensive Care Unit,Shanghai Children′s Medical Center,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)
出处
《中国小儿急救医学》
CAS
2022年第1期12-18,共7页
Chinese Pediatric Emergency Medicine
基金
上海浦东新区科技发展基金(PKJ2018-Y43)。
关键词
应激性心肌病
急性心力衰竭
病理生理学
治疗
预后
儿童
Takotsubo syndrome
Acute heart failure
Pathophysiology
Treatment
Prognosis
Children
作者简介
通信作者:任宏,Email:renhong@scmc.com.cn。
