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We investigated the relationship between myocardial oxidative stress and cardiac sympathetic hyperactivity in patients with takotsubo cardiomyopathy (TC) compared with acute anteroseptal myocardial infarction (AMI). Methods: In 10 TC patients and 10 AMI patients, electrocardiogram, echocardiography, cardiac catheterization were conducted, and plasma catecholamines and urinary (U) 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a marker of oxidative DNA damage were taken for one week from onset. Results: On admission, the coronary sinus (CS) had significantly higher norepinephrine (NE) and 8-OHdG levels than the aortic root (Ao) and peripheral blood vessels. Circulating catecholamines in TC patients tended to be higher than those in AMI patients; especially, peripheral plasma NE levels (day 1) in patients with TC were significantly higher than those in patients with AMI. TC patients had elevated U-8-OHdG in parallel with elevated NE, whereas, AMI patients had U-8-OHdG level that decreased to almost normal range within one week. On day 1, in patients with TC, serum 8-OHdG differences (CS vs Ao) and U-8-OHdG increased proportionally with the wall-motion score as an index of LV dysfunction, whereas serum NE (CS vs Ao) did not. Conclusion: Myocardial oxidative stress induced by cardiac sympathetic hyperactivity may play a critical role in transient LV dysfunction in TC.


  • The bulletin of the Yamaguchi Medical School

    The bulletin of the Yamaguchi Medical School 63(1-2), 5-16, 2016

    Yamaguchi University School of Medicine


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