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Abstract：
The pathophysiology of Takotsubo syndrome (TTS) is incompletely understood. A sympathetic overdrive with coronary microvascular dysfunction might play a central role. The aim of our study was to assess the status of the systemic microcirculation (MC) of patients with TTS, compared to patients with myocardial infarction (MI) and healthy subjects. The systemic microvascular function of 22 TTS patients, 20 patients with MI and 20 healthy subjects was assessed via sublingual sidestream dark-field imaging. In TTS and MI patients, measurements were performed during the acute phase (day 1, 3 and 5) and after 3 months. The measurement in healthy subjects was performed once. The assessed parameters were number of vessel crossings, number of perfused vessel crossings, proportion of perfused vessels, total vessel density and perfused vessel density. The results did not show relevant differences between the investigated groups. Some minor, albeit statistically significant, differences occurred rather randomly. The MC parameters of the TTS group did not show any relevant changes in the temporal course. A systemic microvascular dysfunction could not be identified as a contributing factor in the pathogenesis of TTS. A possible microvascular dysfunction might instead be caused by a local effect restricted to the coronary microvascular bed.
摘要：
Takotsubo综合征（TTS）的病理生理学尚未完全了解。交感神经过激伴冠状动脉微血管功能障碍可能起核心作用。我们研究的目的是评估TTS患者的全身微循环（MC）状态，与心肌梗死（MI）患者和健康受试者相比。22例TTS患者的全身微血管功能，通过舌下侧流暗场成像评估了20例MI患者和20例健康受试者。在TTS和MI患者中，在急性期(第1,3和5天)和3个月后进行测量.在健康受试者中进行一次测量。评估的参数是血管穿越的数量，灌注血管交叉的数量，灌注血管的比例，总血管密度和灌注血管密度。结果没有显示研究组之间的相关差异。一些未成年人，尽管具有统计学意义，差异发生得相当随机。TTS组的MC参数在时间进程中未显示任何相关变化。不能确定系统性微血管功能障碍是TTS发病机理的促成因素。可能的微血管功能障碍可能是由局限于冠状动脉微血管床的局部作用引起的。
