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von Blotzheim LG, Christen S, Wieser S, et al. Evidence for an association between tako-tsubo cardiomyopathy and bronchial asthma: retrospective analysis in a primary care hospital. Open Cardiovasc Med J. 2015;9:1-4doi: 10.2174/1874192401509010001.
von Blotzheim, L. G., Christen, S., Wieser, S., Ulrich, S., & Huber, L. C. (2015). Evidence for an association between tako-tsubo cardiomyopathy and bronchial asthma: retrospective analysis in a primary care hospital. The open cardiovascular medicine journal, 91-4. https://doi.org/10.2174/1874192401509010001
von Blotzheim, Leonardo Glutz, et al. "Evidence for an association between tako-tsubo cardiomyopathy and bronchial asthma: retrospective analysis in a primary care hospital." The open cardiovascular medicine journal vol. 9 (2015): 1-4. doi: https://doi.org/10.2174/1874192401509010001
von Blotzheim LG, Christen S, Wieser S, Ulrich S, Huber LC. Evidence for an association between tako-tsubo cardiomyopathy and bronchial asthma: retrospective analysis in a primary care hospital. Open Cardiovasc Med J. 2015 Feb 27;9:1-4. doi: 10.2174/1874192401509010001. eCollection 2015. PMID: 25767631; PMCID: PMC4353125.
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Open Cardiovasc Med J. 2015 Feb 27;9:1-4. doi: 10.2174/1874192401509010001. eCollection 2015.

Evidence for an association between tako-tsubo cardiomyopathy and bronchial asthma: retrospective analysis in a primary care hospital.

The open cardiovascular medicine journal

Leonardo Glutz von Blotzheim, Stefan Christen, Stephan Wieser, Silvia Ulrich, Lars C Huber

Affiliations

  1. Division of Cardiology, Waid City Hospital, Zurich, Switzerland ; Department of Internal Medicine, Citizen's Hospital Solothurn, Switzerland.
  2. Division of Cardiology, Waid City Hospital, Zurich, Switzerland.
  3. Division of Pulmonology, Waid City Hospital, Zurich, Switzerland.
  4. Division of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.
  5. Division of Pulmonology, Waid City Hospital, Zurich, Switzerland ; Division of Pulmonology, University Hospital of Zurich, Zurich, Switzerland.

PMID: 25767631 PMCID: PMC4353125 DOI: 10.2174/1874192401509010001

Abstract

OBJECTIVE: We investigated the prevalence of bronchial asthma in patients with Tako-Tsubo Syndrome (TTS).

DESIGN: This retrospective case-series study was conducted in a primary care hospital in Zurich, Switzerland. Data of all patients with newly diagnosed TTS (2002 - 2012) were assessed electronically by the use of ICD-10. Asthma prevalence was compared to published epidemiologic data.

SETTING: Bronchial asthma is characterized by airway inflammation and, during attack, release of endogenous catecholamines. Sympathomimetic drugs are the mainstay of treatment for asthma patients. Likewise, catecholamine mediated diffuse microvascular myocardial dysfunction seems to be of critical importance for the development of TTS.

RESULTS: 20 cases of TTS were identified. 90% were female, showed a median age of 70±13y [25y - 90y], an apical and/or midventricular ballooning pattern with preserved basal function and a median initial LVEF of 34±9% [25% - 55%]. 65% of patients underwent coronary angiography to rule out significant coronary artery disease. Hypertension was present in 45% of patients, 35% were smokers, none was suffering from diabetes. Prevalence of asthma in patients with TTS was significantly higher compared to the normal population (25% vs. 7%, p=0.012). In 30% of the TTS patients an iatrogenic cause for development of TTS was identified.

CONCLUSION: Prevalence of asthma was significantly higher in patients with TTS compared to epidemiologic data from an age-matched population. Phenotypes of patients developing obstructive ventilatory disease and TTS might share common pathogenic mechanisms beyond the use of bronchodilatators. In addition, we identified other iatrogenic etiologies in patients with TTS.

Keywords: Bronchial asthma; Tako-Tsubo-Syndrome; sympathomimetic drugs

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