While the first part of the scientific statement on the pathophysiology of Takotsubo syndrome was focused on catecholamines and the sympathetic nervous system, in the second part we focus on the vascular pathophysiology including coronary and systemic vascular responses, the role of the central and peripheral nervous systems during the acute phase and abnormalities in the subacute phase, the gender differences and integrated effects of sex hormones, genetics of Takotsubo syndrome including insights from microRNA studies and inducible pluripotent stem cell models of Takotsubo syndrome. We then discuss the chronic abnormalities of cardiovascular physiology in survivors, the limitations of current clinical and preclinical studies, the implications of the knowledge of pathophysiology for clinical management and future perspectives and directions of research.

中文翻译：

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Takotsubo 综合征的病理生理学——来自心力衰竭协会 Takotsubo 综合征研究组和欧洲心脏病学会心肌功能工作组的联合科学声明——第 2 部分：血管病理生理学、性别和性激素、遗传学、慢性心血管问题和临床意义

虽然关于 Takotsubo 综合征病理生理学的科学声明的第一部分侧重于儿茶酚胺和交感神经系统，但在第二部分中，我们侧重于血管病理生理学，包括冠状动脉和全身血管反应、中枢和周围神经系统的作用在急性期和亚急性期异常，性激素的性别差异和综合影响，Takotsubo 综合征的遗传学，包括来自 microRNA 研究的见解和 Takotsubo 综合征的可诱导多能干细胞模型。然后，我们讨论幸存者心血管生理学的慢性异常，当前临床和临床前研究的局限性，