Characterization of the Myocardial Inflammatory Response in Acute Stress-Induced (Takotsubo) Cardiomyopathy

JACC Basic Transl Sci. 2018 Dec 31;3(6):766-778. doi: 10.1016/j.jacbts.2018.08.006. eCollection 2018 Dec.

Abstract

Takotsubo cardiomyopathy is an acute stress-induced heart failure syndrome for which the exact pathogenic mechanisms are unclear, and consequently, no specific treatment exists. In an experimental model of stress-induced takotsubo-like cardiomyopathy, the authors describe the temporal course of a chronic inflammatory response post-induction, with an initial early influx of neutrophils into myocardial tissue followed by macrophages that are typical of a proinflammatory M1 phenotype, and a nonsignificant increase in systemic inflammatory cytokines. Post-mortem myocardium from the more complex clinical takotsubo patients share features of the study's experimental model. These findings suggest modulators of inflammation could be a potential therapeutic option.

Keywords: EF, ejection fraction; IL, interleukin; MHC, major histocompatibility complex; MI, myocardial infarction; TNFα, tumor necrosis factor-alpha; histopathology; inflammation; macrophage; pathophysiology; qPCR, quantitative polymerase chain reaction; takotsubo cardiomyopathy.