Background: Takotsubo cardiomyopathy (TTC) is a syndrome of acute non-coronary heart failure with similar symptoms and electrocardiograms to acute anterior ST-elevation myocardial infarction (STEMI). Little is known about the pathophysiology of TTC. We assessed admission plasma concentrations of biomarkers reflecting neuroendocrine response (copeptin, mid-regional-pro-adrenomedullin, pro-atrial-natriuretic-peptide, soluble thrombomodulin (sTM), syndecan-1) and inflammation (suppression-of-tumorigenicity 2 (ST2), high-sensitive C-reactive-protein) in TTC patients and compared to patients with acute anterior STEMI.

Materials and methods: Twenty TTC patients were matched with 40 STEMI patients by age, gender and left ventricular ejection fraction. Blood was sampled upon hospital admission immediately before acute coronary angiography.

Results: The groups had similar comorbidities. TTC patients had higher plasma concentrations of sTM: 7.94 (5.89;9.61) vs. 6.42 (5.50;7.82)ng/ml, p = 0.04 and ST2 (53 (32;157) vs. 45 (31;55)ng/ml, p = 0.008) and higher heart rate: 101 ($\pm$33) vs. 76($\pm$14)bpm, p = 0.0001, but lower concentrations of copeptin (10.4 (7.6;39) vs. 92.3 (13;197)pmol/l, p < 0.05) and troponin T (348 (98;759) vs. 1190 (261;4105)ng/l, p = 0.04).

Conclusion: TTC patients had higher plasma concentrations of sTM and ST2, higher heart rate and lower copeptin and troponin T concentrations compared to acute anterior STEMI patients. This study contributes to the hypothesis that TTC patients have endothelial cell damage and are hemodynamically more stable than patients with acute anterior STEMI on admission.

背景： Takotsubo心肌病（TTC）是一种急性非冠心病综合征，其症状和心电图与急性前ST抬高型心肌梗死（STEMI）相似。关于TTC的病理生理知之甚少。我们评估了反映神经内分泌反应（肽素，中区肾上腺髓质素原，心房利钠肽前体，可溶性血栓调节蛋白（sTM），syndecan-1）和炎症（抑制致瘤性2（ST2）的生物标志物的入院血浆浓度），高敏感性C反应蛋白）与急性前STEMI患者进行比较。

材料和方法：按年龄，性别和左心室射血分数将20例TTC患者与40例STEMI患者配对。急性冠脉造影之前不久入院时就进行了血液采样。

结果：各组合并症相似。TTC患者的sTM血浆浓度更高：7.94（5.89; 9.61）对6.42（5.50; 7.82）ng / ml，p  = 0.04和ST2（53（32; 157）对45（31; 55）ng / ml ，p  = 0.008）和更高的心率：101（$\pm$33）和76（$\pm$14）bpm，p  = 0.0001，但肽素（10.4（7.6; 39）vs.92.3（13; 197）pmol / l，p  <0.05）和肌钙蛋白T（348（98; 759）vs.1190（更低） 261; 4105）ng / l，p  = 0.04）。

结论：与急性前壁STEMI患者相比，TTC患者的sTM和ST2血浆浓度较高，心率较高，而肽素和肌钙蛋白T浓度较低。这项研究有助于假说TTC患者入院时具有内皮细胞损伤，并且在血液动力学方面比急性前STEMI患者更稳定。