在急性应激性心肌病 (Takotsubo) 中心肌和全身炎症
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Caroline Scally1, Hassan Abbas1, Trevor Ahearn1
1Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Circulation
|December 28, 2018
概括
在takotsubo心肌病中,炎症起着关键作用,可观察到炎症标志物增加和巨细胞透. 这些炎症变化持续至少五个月,表明慢性炎症状态.
科学领域:
- 心脏病学
- 免疫学
- 医学成像
背景情况:
- 压力引起的心肌病, 模仿心肌梗塞, 可能导致心力衰竭.
- 恐怖心肌病的病理生理学和长期预后尚未完全了解.
- 这项研究研究了炎症在takotsubo心肌病中的作用.
研究的目的:
- 为了确定炎症是否是Takotsubo心肌病的核心病理生理学.
- 评估心肌炎症和系统性炎症标志物在患有takotsubo心肌病的患者.
- 评估炎症变化的持续时间.
主要方法:
- 一项多中心前性研究,涉及55名心肌病患者和51名匹配对照.
- 多参数心脏MRI与超微型超磁性氧化铁 (USPIO) 增强检测心肌巨细胞.
- 对全身炎症的血液单细胞亚群和血清细胞因子的评估.
主要成果:
- 与对照组相比,takotsubo心肌病患者在左心室显示USPIO增强.
- 在takotsubo心肌病患者中发现血清中介质素-6和化学因子1的升高,以及单细胞子集的改变.
- 心肌USPIO增强在5个月后消失,但增加的互白素-6和改变的单细胞子集仍然存在.
结论:
- 塔科苏博心肌病的特征是心肌炎症,单细胞分布的改变,以及全身性炎症性细胞因子的增加.
- 这些炎症变化表明慢性轻度炎症至少持续5个月.
- 炎症是takotsubo心肌病的病理生理学和自然史的一个关键组成部分.
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