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A narrative review on gender disparities in the pathogenesis and pathophysiology of Takotsubo syndrome: Implications for novel approaches to treatment?

Carola Y. Förster1* ,  Martin J. Herrmann2
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1 Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg University, Würzburg, Germany
2 Center of Mental Health, Department of Psychiatry and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
INNOSC Theranostics and Pharmacological Sciences 2024, 7(4), 3142 https://doi.org/10.36922/itps.3142
Submitted: 11 March 2024 | Accepted: 30 May 2024 | Published: 19 September 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

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.

Keywords
Takotsubo syndrome
Heart-brain
Inflammation
Gender
Central autonomic network
Stress
Funding
This work is supported by research grant DFG FO 315/5-1 awarded to C.Y.F.
Conflict of interest
The authors declare they have no competing interests.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Print ISSN: 2705-0734, Published by AccScience Publishing
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