Cardiomiopatia di Tako Tsubo: Mia Lettera a Cardiologi e peer-Reviewes
Infiniti casi di Sindrome di Tako Tsubo, una cardiopatia dai molti nomi, caratterizzata da coronarie normali, che colpisce il microcircolo della regione apicale sinistra, sono diagnosticati come crisi coronarica acuta.
A giorni nel sito sella Società Internazionale di Semeiotica Biofisica Quantistica, http://www.sisbq.org, sarà pubblicato nel Journal of SISBQ ul articolo che – spero – porterà conoscenze nuove nella fisiopatologia della Cardiomiopatia di Tako Tsubo, a patto che chi leggerà conosca la Semeiotic Biofisica Quantistica, ovviamente!
25 February, 2012.
Letter to all Editors
Quantum Biophysical Semeiotics Enlightens Tako Tsubo Cardiomyopathy
To All Editors,
regarding the role played by tissue-microvascular-unit, TMU (still termed as microcirculatory bed, in English countries!) in pathophysiology of Tako Tsubo cardiomyopathy there are till now confounding data (1), because of microcirculation in TMU cannot be properly, accurately, in refined way, investigated “in vivo”, despite SPECT, CMR, Contrast Echocardiogram, a.s.o.
At the present time, the only efficient method is a CLINICAL one: Quantum Biophysical Semeiotics, QBS (www.semeioticabiofisica.it).
As a matter of facts, either ignoring or overlooking QBS, nobody can speak of the fundamental, heritable “microcirculatory remodelling”, localized in LEFT apical region – but not in the right one – because Authors do not know, or perhaps overlook, beside type II, type I, physiological, and newborn-pathological, subtype a) oncological and b) aspecific, Endoarteriolar Blocking Devices! (2, 3)
The possibility of myocardial injury due to microvascular “spasm” has also been suggested (1), because the Authors ignore QBS. For instance, Ako and co-workers (4), by the use of an intracoronary Doppler wire technique, demonstrated microcirculation impairments in instances of transient LV hypocontraction. From the QBS Clinical Microcirculatory such a term sound trivial, no-updated, no precise and confounding, demonstrating that the perfect, complex interactions between the diverse components of TMU, i.e. numerous type I, group A end B, type B, group I and II, AVA, according to Bucciante, Endoarteriolar Blocking Devices, including the above.cited ones, I have discovered (2-3), not to speak of wonderful chaotic-deterministic dynamics of vasomotility and vasomotion, according to S.B. Curry.
Transient LV “hypocontraction” explanation, in my opinion, is misleading and distressingly simple. Notoriously, data on microscopic findings in some patients who had LV apical ballooning were different from those in patients who had myocardial ischemia (5). Authors state that the most common pathologic finding in Tako Tsubo cardiomyopathy, heart broken syndrome, is not typically seen in patients with myocardial infarction (6). Unfortunately, these Authors ignore QSB, so that cannot understand the real different data in these different heart disorders (7).
It is distressing to read that in several cases, coronary angiography failed to reveal the slow-flow phenomenon, even in the presence of ST-segment elevation: in the acute episode of Tako Tsubo cardiomyopathy, physician observes microcirculatory disactivation exclusively in the LEFT – not right – apical region, typical sign of such a syndrome.
From Clinical Microangiology view-point (8), the phrase “impaired microcirculation during the acute phase is not direct evidence of causation, because microcirculatory impairment can result from a primary myocardial injury” (5), indicates that Authors, “Professors” and Physicians around the world have to learn Quantum Biophysical Semeiotics, aiming to leave finally the present Middle Ages of Medicine (9).
Based on a mitochondrial cytopathy, heritable by mother, I have discovered 32 years ago, (10), as all other common and serious disorders, like CAD, type 2 DM, and Cancer, Tako Tsubo cardiomyopathy is characterized SINCE BIRTH by a typical microvascular remodelling, wherein type I, subtype b) aspecific , physiological Endoarteriolar Blocking Devices plays a central role, allowing doctors to bedside recognizing this syndrome (7).
1) Kurisu S, Sato H, Kawagoe T, Ishihara M, Shimatani Y, Nishioka K, et al. Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction. Am Heart J 2002;143:448–55. [PubMed]
2) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, 2009.
3) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. IAS, www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp
4) Ako J, Takenaka K, Uno K, Nakamura F, Shoji T, Iijima K, et al. Reversible left ventricular systolic dysfunction–reversibility of coronary microvascular abnormality. Jpn Heart J 2001;42:355–63. [PubMed]
5) Salim S. Virani, A. Nasser Khan, Cesar E. Mendoza, et al. Takatsubo Cardiomyopathy, or Broken-Heart Syndrome Tex Heart Inst J. 2007; 34(1): 76–79. PMCID: PMC1847940
6) Akashi YJ, Nakazawa K, Sakakibara M, Miyake F, Koike H, Sasaka K. The clinical features of takotsubo cardiomyopathy. QJM 2003;96:563–73. [PubMed]
7) Stagnaro S, Caramel Simone. Sinisalchi’s Syndrome in Bedside Diagnosing Taka Tsubo Cardiomyopathy, or Heart Broken Heart. In press Journal of Quantum Biophysical Semeiotics. http://www.sisbq.org/journal-of-quantum-biophysical-semeiotics1.html
8) Sergio Stagnaro and Simone Caramel (2012) Attivazione Microcircolatoria con Prove da Sforzo nella Diagnosi del Reale Rischio Congenito, aspecifico ed oncologico. www.sisbq.org, Journal of Quantum Biophysical Semeiotics. http://www.sisbq.org/uploads/5/6/8/7/5687930/amprovedasforzo.pdf
9) Stagnaro Sergio. Middle Ages of today’s Medicine, Overlooking Quantum-Biophysical-Semeiotic Constitutions and Related Inherited Real Risk. http://sciphu.com November 4, 2008. http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html
10) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz Med. It. – Asch. Sci, Med. 144, 423, 1985.
La Voce di SergioStagnaro 