The Sympathetic Nervous System in the Pathogenesis of Takotsubo Syndrome

Research output: Contribution to journalReview articlepeer-review


Takotsubo syndrome is a unique clinical condition of acute heart failure and reversible left ventricular dysfunction frequently precipitated by sudden emotional or physical stress. There is growing evidence that exaggerated sympathetic stimulation is central to the pathogenesis of this syndrome. Precisely how catecholamines mediate myocardial stunning in takotsubo syndrome remains incompletely understood; but possible mechanisms include epicardial spasm, microvascular dysfunction, direct adrenergic-receptor–mediated myocyte injury, and systemic vascular effects that alter ventricular-arterial coupling. Risk factors that increase sympathetic tone and/or catecholamine sensitivity may render individuals particularly susceptible to takotsubo syndrome during episodes of acute stress.

Original languageEnglish (US)
Pages (from-to)485-498
Number of pages14
JournalHeart Failure Clinics
Issue number4
StatePublished - Oct 1 2016


  • Catecholamines
  • Stress cardiomyopathy
  • Sympathetic nervous system
  • Takotsubo syndrome
  • Ventricular ballooning

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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