A narrative review on gender disparities in the pathogenesis and pathophysiology of Takotsubo syndrome: Implications for novel approaches to treatment?
Takotsubo syndrome is a type of cardiomyopathy characterized by transient and reversible left ventricular wall motion abnormalities within the ventricle. Depending on the severity of the injury, recovery can occur within a few hours or weeks. According to studies, older people are more likely to be affected by it, and the prevalence is particularly high among postmenopausal women. Stress factors, both physical and emotional, are widely discussed and generally recognized as triggers. The hypothalamic-pituitary-adrenal axis and its glucocorticoid-dependent negative feedback also play important roles in the resulting gender-specific immune response. Transcutaneous vagus nerve stimulation is proposed as a potential novel personalized therapeutic strategy in light of the gender disparities in autonomous nervous system activity and inflammatory response. Considering the modifiable risks involved in this pathology, such as stress which affects the heart and psychology, a strong emphasis should be placed on preventive medicine. In this paper, we propose the use of non-invasive (transcutaneous) vagus nerve stimulation, as a means of dampening sympathetic overdrive with negligible side effects.
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