Tako-Tsubo Syndrome in Amyotrophic Lateral Sclerosis: Single-Center Case Series and Brief Literature Review
Abstract
:1. Introduction
2. Case Presentation
2.1. Case Series
2.2. Literature Review
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Patient (Sex) | 1 (Case Report, M) | 2 (F) | 3 (M) | 4 (F) |
---|---|---|---|---|
ALS age of onset (years) | 54 | 74 | 60 | 71 |
Site of onset | Upper limbs | Bulbar | Lower limbs | Lower limbs |
ALS phenotype (according to Chiò, et al. 2011 [2]) | Classic | Bulbar | LMN | Classic |
ALS disease duration (from clinical onset) | 73 months | 19 months (†) | 103 months (†) | 38 months (†) |
TTS (months after ALS onset) | 73 months | 11 months | 86 months | 38 months |
Awaji at ALS diagnosis | Probable | Probable | Possible | Possible |
ALSFRS-R * | 15 | 45 | 19 | 18 |
KSS * | 4 | 1 | 4 | 4 |
MiToS * | 3 | 1 | 3 | 3 |
ALS genetics | / | C9orf72 | / | / |
Concomitant Medication | Riluzole, Acetyl-L-carnitine | Riluzole, Acetyl-L-carnitine, Baclofen | Riluzole | Riluzole |
Time to Ventilation | 73 months | N/A | 86 months | 32 months |
Time to Tracheostomy | N/A | N/A | 91 months | 38 months |
Time to PEG | 75 months | N/A | N/A | 38 months |
Elevated ST/negative T at ECG | Prolonged QT, unspecific T wave alterations | Sinus tachycardia, VEBs | Negative antero-septal T | Aspecific conduction alterations |
Troponin T (ng/dL) | 231 | 421 | 459 | 316 |
pro-BNP (pg/mL) | 939 | 34.309 | 3.074 | / |
CPK (U/L) | N/A | 44 | 71 | 49 |
Ejection Fraction | 45% | 30% | 35% | 35% |
Apical dyskinesia/ballooning at echocardiography | Yes | Yes | Yes | Yes |
Coronary CT/coronarography | Heart angio-CT: negative | Coronarography: negative | N/A | Heart CT: negative |
Pulmonary arterial Pressure | Normal | 75 mmHg | Normal | Normal |
Cardiovascular comorbidities | PSVT | HT | HT | T2DM, CAD |
Intervening condition | Respiratory failure (adapted to NIV) | PE | PE + lower UTI | TS + PEG |
Reference | Number of Cases | Type of Onset | Ventilatory Support | Bulbar Signs | Intervening Conditions |
---|---|---|---|---|---|
Takayama et al., 2004 [12] | 1 | Classic | N/A | N/A | Surgical gastrostomy; repair of incisional hernia (with tracheal intubation) |
Mitani et al., 2005 [11] | 1 | Bulbar | NIV | Dysphagia, dysarthria. | Long-term NIV |
Matsuyama et al., 2008 [10] | 1 | Classic | TIV | N/A | Tracheostomy |
Massari et al., 2011 [19] | 1 | Classic | NIV | Dysphagia, dysarthria | Pneumonia |
Peters, 2014 [22] | 1 | N/A | NIV | N/A | Respiratory distress syndrome, pneumonia |
Santoro et al., 2016 [23] | 1 | N/A | N/A | N/A | Emotional distress (first episode); Femoral artery thrombosis (second episode) |
Gdynia et al., 2006 [24] | 1 | Classic | N/A | N/A | Major surgery |
Choi et al., 2017 [20] | 9 | Bulbar (pt.2,5,6) Cervical (pt.1,3,4,7,8) Respiratory (pt.9) | NIV (pt.2,5,7), TIV (pt.6,8) | N/A | N/A |
Izumi et al., 2018 [13] | 4 | Bulbar (pt.1,4), Classic (pt.2,3) | TIV (pt.1,2) | N/A | UTI (pt.1); acute cholangitis (pt.2); pneumonia (pt.3) |
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Napoli, G.; Rubin, M.; Cutillo, G.; Schito, P.; Russo, T.; Quattrini, A.; Filippi, M.; Riva, N. Tako-Tsubo Syndrome in Amyotrophic Lateral Sclerosis: Single-Center Case Series and Brief Literature Review. Int. J. Mol. Sci. 2023, 24, 12096. https://doi.org/10.3390/ijms241512096
Napoli G, Rubin M, Cutillo G, Schito P, Russo T, Quattrini A, Filippi M, Riva N. Tako-Tsubo Syndrome in Amyotrophic Lateral Sclerosis: Single-Center Case Series and Brief Literature Review. International Journal of Molecular Sciences. 2023; 24(15):12096. https://doi.org/10.3390/ijms241512096
Chicago/Turabian StyleNapoli, Giovanni, Martina Rubin, Gianni Cutillo, Paride Schito, Tommaso Russo, Angelo Quattrini, Massimo Filippi, and Nilo Riva. 2023. "Tako-Tsubo Syndrome in Amyotrophic Lateral Sclerosis: Single-Center Case Series and Brief Literature Review" International Journal of Molecular Sciences 24, no. 15: 12096. https://doi.org/10.3390/ijms241512096