.
ÕÚıÚÔ ∞Ó·ÛÎfiËÛ˘
ª˘ÔηډÈÔ¿ıÂÈ· Tako-Tsubo: ∆Ô ™‡Ó‰ÚÔÌÔ Ù˘
“ƒ·ÁÈṲ̂Ó˘ K·Ú‰È¿˜”
™¶ÀƒI¢ø¡ ∫OÀ§OYƒ∏™, ™ø∫ƒA∆∏™ ¶∞™∆ƒøªA™, ¢∏ª∏∆ƒπO™ ™∞∫∂§§∞ƒπOÀ,
£∂O¢øƒO™ ∫ƒ∞∆∏ª∂¡√™, ¶§OÀ∆∞ƒÃO™ ¶π¶∂ƒ√¶OÀ§O™, ∞¡∆ø¡∏™ ™. ª∞¡ø§∏™
.
∏
¢È‡ı˘ÓÛË
EÈÎÔÈÓˆÓ›·˜:
™˘Ú›‰ˆÓ KÔ˘ÏÔ‡Ú˘
K¤ÎÚÔÔ˜ 64, M·ÚÔ‡ÛÈ
151 25 Aı‹Ó·
e-mail:
[email protected]
.com
Ì˘ÔηډÈÔ¿ıÂÈ· Tako-Tsubo
(TTC), Â›Ó·È ÌÈ· Û¿ÓÈ· ÎÏÈÓÈ΋
ÔÓÙfiÙËÙ· Ô˘ ÌÈÌÂ›Ù·È ÙÔ Ô͇ ÛÙÂÊ·ÓÈ·›Ô Û‡Ó‰ÚÔÌÔ ·ÏÏ¿ ÔÏϤ˜ ÊÔÚ¤˜
˘ԉȷÁÈÁÓÒÛÎÂÙ·È. ∆· ·ÚÈ· ¯·Ú·ÎÙËÚÈÛÙÈο Ù˘ ›ӷÈ: ÔÈÛıÔÛÙÂÚÓÈÎfi ¿ÏÁÔ˜,
ÈÛ¯·ÈÌÈΤ˜ ·ÏÏÔÈÒÛÂȘ ÛÙÔ ËÏÂÎÙÚÔηډÈÔÁÚ¿ÊËÌ· (∏∫°), ÂÏ·ÊÚ¿ ·‡ÍËÛË ÙˆÓ
ηډȷÎÒÓ ÂÓ˙‡ÌˆÓ Î·È ÙÌËÌ·ÙÈΤ˜ ‰È·Ù·Ú·¯¤˜ Ù˘ ÎÈÓËÙÈÎfiÙËÙ·˜ Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜. ¶ÚÒÙË ÊÔÚ¿ ÂÚÈÁÚ¿ÊËÎÂ ·fi
ÙÔ˘˜ Hikaru Sato Î·È Û˘Ó.1 ÛÙȘ ·Ú¯¤˜ Ù˘
ÚÔËÁÔ‡ÌÂÓ˘ ‰ÂηÂÙ›·˜ ÛÙËÓ π·ˆÓ›·.
∏ ÔÓÔÌ·Û›· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ÔÊ›ÏÂÙ·È
ÛÙÔ ÁÂÁÔÓfi˜ fiÙÈ ÛÙËÓ ÎÏ·ÛÛÈ΋ ÌÔÚÊ‹
Ù˘ ÓfiÛÔ˘ Ë ·ÚÈÛÙÂÚ‹ ÎÔÈÏ›· ÛÙËÓ Û˘ÛÙÔÏ‹ ¤¯ÂÈ ÙÔ Û¯‹Ì· ÙÔ˘ “tako-tsubo”, ÂÓfi˜
‰Ô¯Â›Ô˘ ÁÈ· ·Á›‰Â˘ÛË ¯Ù·Ô‰ÈÒÓ Ô˘
¯ÚËÛÈÌÔÔÈÂ›Ù·È ÛÙËÓ π·ˆÓ›· Î·È ¤¯ÂÈ
ÛÙÂÓfi ·˘¯¤Ó· Î·È Â˘Ú›· ΢ÎÏÈ΋ ‚¿ÛË
(∂ÈÎfiÓ· 1). ∞Ú¯Èο ˘‹Ú¯Â Ë ·ÓÙ›ÏË„Ë
fiÙÈ ÙÔ Û‡Ó‰ÚÔÌÔ ÂÌÊ·Ó›˙ÔÓÙ·Ó ·ÔÎÏÂÈÛÙÈο ÛÙÔ˘˜ π¿ˆÓ˜ ÏfiÁˆ οÔÈÔ˘
¿ÁÓˆÛÙÔ˘ ÁÂÓÂÙÈÎÔ‡ ‹ ÂÚÈ‚·ÏÏÔÓÙÈÎÔ‡
ÚԉȷıÂÛÈÎÔ‡ ·Ú¿ÁÔÓÙ·.2 ∆ËÓ ÙÂÏÂ˘Ù·›· ‰ÂηÂÙ›· fï˜ ¤¯Ô˘Ó ÂÚÈÁÚ·Ê›
ÔÏÏ¿ ÂÚÈÛÙ·ÙÈο ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ·ÁÎÔÛÌ›ˆ˜ ηٷÚÚ›ÙÔÓÙ·˜ ÙË ıˆڛ· Ù˘
ÁˆÁÚ·ÊÈο ·ÔÌÔӈ̤Ó˘ ÓfiÛÔ˘. ∂›Û˘, ¤¯Ô˘Ó ÂÚÈÁÚ·Ê› ‰È¿ÊÔÚ˜ ÌÔÚʤ˜
ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ Ô˘ ÂÚÈÏ¿Ì‚·Ó·Ó ‰È¿ÊÔÚ· ÙÌ‹Ì·Ù· ÙÔ˘ ÙÔȯÒÌ·ÙÔ˜ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜. ¢È¿ÊÔÚ· ÔÓfiÌ·Ù· ¤¯Ô˘Ó
ηٿ ηÈÚÔ‡˜ ‰Ôı› ÛÙÔ Û‡Ó‰ÚÔÌÔ ·˘Ùfi
(Ì˘ÔηډÈÔ¿ıÂÈ· ·fi stress, Ì˘ÔηډÈÔ¿ıÂÈ· “ampulla”, ·ÚÔ‰È΋ ·Ó·‰È·ÌfiÚʈÛË Ù˘ ÎÔÚ˘Ê‹˜ Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜ “‰›ÎËÓ Ì·ÏÔÓÈÔ‡’’, Û‡Ó‰ÚÔÌÔ
“Ú·ÁÈṲ̂Ó˘ ηډȿ˜”, Ó¢ÚÔÁÂÓ‹˜ Ì˘Ôηډȷ΋ ·ÔÏËÍ›·). ∆ÂÏÈο, ÙÔ 2006
Ù·ÍÈÓÔÌ‹ıËΠÛÙÔÓ Î·Ù¿ÏÔÁÔ ÙˆÓ Â›ÎÙËÙˆÓ Ì˘ÔηډÈÔ·ıÂÈÒÓ ˘fi ÙÔ fiÓÔÌ·
“Ì˘ÔηډÈÔ¿ıÂÈ· ·fi stress”.3 ŒÓ· ÛËÌ·ÓÙÈÎfi ÛÙÚÂÛÛÔÁfiÓÔ ÂÚ¤ıÈÛÌ· (Ê˘ÛÈÎfi
‹ Û˘Ó·ÈÛıËÌ·ÙÈÎfi) ÚÔηÏ› ÙËÓ ¤Ó·ÚÍË
ÙˆÓ Û˘ÌÙˆÌ¿ÙˆÓ ·Ó Î·È ‰ÂÓ Î·Ù·ÁÚ¿ÊÂÙ·È ÛÙÔ ÈÛÙÔÚÈÎfi fiÏˆÓ ÙˆÓ ·ÛıÂÓÒÓ. ∏
ÔÚ›· Ù˘ ÓfiÛÔ˘ Â›Ó·È Î·ÏÔ‹ı˘ ηÈ
ÛÙËÓ ÏÂÈÔÓfiÙËÙ· ÙˆÓ ÂÚÈÙÒÛÂˆÓ ·Ó·Ì¤ÓÂÙ·È Ï‹Ú˘ ·ÔηٿÛÙ·ÛË Û ÌÂÚÈΤ˜ ‚‰ÔÌ¿‰Â˜.
∂ȉËÌÈÔÏÔÁ›·
∏ ·ÎÚÈ‚‹˜ Â›ÙˆÛË Ù˘ ÓfiÛÔ˘ ·Ú·Ì¤ÓÂÈ ¿ÁÓˆÛÙË. ™ÙËÓ π·ˆÓ›· ˘ÔÏÔÁ›˙ÂÙ·È
fiÙÈ ·ÓÙÈÚÔÛˆ‡ÂÈ ÙÔ 1-2% ÙˆÓ ÂÈÛ·ÁˆÁÒÓ ÛÙÔ ¡ÔÛÔÎÔÌÂ›Ô ÏfiÁˆ ÔÈÛıÔÛÙÂÚÓÈÎÔ‡ ¿ÏÁÔ˘˜ Î·È ‰˘Ó·ÌÈÎÒÓ ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈÎÒÓ ·ÏÏÔÈÒÛˆÓ. 4 ™ÙȘ
∏.¶.∞ ˘ÔÏÔÁ›˙ÂÙ·È fiÙÈ ÙÔ 2-2,2% ÙˆÓ
·ÛıÂÓÒÓ Ô˘ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÛÙÔ ∆Ì‹Ì·
∂ÂÈÁfiÓÙˆÓ Ì ÂÈÎfiÓ· ·ÛÙ·ıÔ‡˜ ÛÙËı¿Á¯Ë˜ ‹ ÔͤԘ ÂÌÊÚ¿ÁÌ·ÙÔ˜ ÙÔ˘ Ì˘Ôηډ›Ô˘ Ì ·Ó¿Û·ÛË ÙÔ˘ ST (STEMI) ÂͤگÔÓÙ·È Ì ÙË ‰È¿ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘
.
∂ÈÎfiÓ· 1. ∆Ô ‰Ô¯Â›Ô Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡Ó ÔÈ π¿ˆÓ˜ ÁÈ· ÙËÓ ·Á›‰Â˘ÛË ¯Ù·Ô‰ÈÒÓ (Tako – tsubo pot).
Tako Tsubo.5,6 º·›ÓÂÙ·È fï˜ fiÙÈ ·˘Ù¿ Ù· ÔÛÔÛÙ¿
˘ÔÂÎÙÈÌÔ‡Ó ÙËÓ Ú·ÁÌ·ÙÈ΋ Â›ÙˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ·ÊÔ‡ Ì ÙȘ Û‡Á¯ÚÔÓ˜ Ù¯ÓÈΤ˜ ·ÓÙÈÌÂÙÒÈÛ˘
ÙˆÓ ÔͤˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ Û˘Ó‰ÚfiÌˆÓ (ıÚÔÌ‚fiÏ˘ÛË
Î·È ÚˆÙÔÁÂÓ‹˜ ·ÁÁÂÈÔÏ·ÛÙÈ΋), Ë ‰È¿ÁÓˆÛË ÙÔ˘
Û˘Ó‰ÚfiÌÔ˘ ‰È·Ê‡ÁÂÈ Û ÔÏϤ˜ ÂÚÈÙÒÛÂȘ. ∂›Ó·È
¯·Ú·ÎÙËÚÈÛÙÈÎfi fiÙÈ ·fi ÙfiÙ Ô˘ ÙÔ Û‡Ó‰ÚÔÌÔ ¤ÁÈÓÂ
¢ڤˆ˜ ÁÓˆÛÙfi Î·È ıÂÛ›ÛÙËÎ·Ó Û˘ÁÎÂÎÚÈ̤ӷ ‰È·ÁÓˆÛÙÈο ÎÚÈÙ‹ÚÈ· ·Ó·Ê¤ÚÔÓÙ·È Û ‰È¿ÊÔÚ˜ ÌÂϤÙ˜ ÌÂÁ·Ï‡ÙÂÚ· ÔÛÔÛÙ¿ ÂÌÊ¿ÓÈÛ˘ (.¯. Û ÚfiÛÊ·ÙË ÌÂϤÙË ÙÔ˘ Facciorusso Î·È Û˘Ó.7 ·Ó·Ê¤ÚÂÙ·È
Â›ÙˆÛË Ù˘ ÓfiÛÔ˘ 4,78%).
∂ÈϤÔÓ, ÌÂϤÙ˜ Û ÂȉÈΤ˜ ÏËı˘ÛÌȷΤ˜ ÔÌ¿‰Â˜ ¤¯Ô˘Ó ‰Â›ÍÂÈ Ôχ ˘„ËÏfiÙÂÚ· ÔÛÔÛÙ¿ ÂÌÊ¿ÓÈÛ˘ ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘. ™Â ÌÂϤÙË ÙˆÓ Park Î·È Û˘Ó. 8
‚Ú¤ıËΠfiÙÈ ÛÙÔ 33% ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ‰È·ÎÔÌ›ÛÙËÎ·Ó ÛÙËÓ ªÔÓ¿‰· ∂ÓÙ·ÙÈ΋˜ £ÂÚ·›·˜ Ì ÌË Î·Ú‰ÈÔÏÔÁÈÎfi Úfi‚ÏËÌ· (·Ó·Ó¢ÛÙÈ΋ ·ÓÂ¿ÚÎÂÈ· ‹
Û‹„Ë) ‰È·ÁÓÒÛÙËΠTTC. ™Â ÌÈ· ÌÂϤÙË ÙˆÓ Hartting Î·È Û˘Ó. 9 ‰È·ÈÛÙÒıËΠ·˘ÍË̤ÓË Â›ÙˆÛË
¯ÚfiÓÈ·˜ ·ÔÊÚ·ÎÙÈ΋˜ Ó¢ÌÔÓÔ¿ıÂÈ·˜ ‹ ‚ÚÔÁ¯ÈÎÔ‡ ¿ÛıÌ·ÙÔ˜ Û 32 ·ÛıÂÓ›˜ Ô˘ ·Ó·‰ÚÔÌÈο ‰È·ÁÓÒÛÙËΠTTC. ∂›Û˘, ¤¯Ô˘Ó ·Ó·ÊÂÚı› ˘„ËÏ¿ ÔÛÔÛÙ¿ ˘¤ÚÙ·Û˘ ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ì TTC (76% Û‡Ìʈӷ Ì ÌÈ· ÌÂϤÙË10). ŸÏ· ·˘Ù¿ Ù· Â˘Ú‹Ì·Ù· ÂÓÈÛ¯‡Ô˘Ó ÙËÓ ¿Ô„Ë fiÙÈ ÌÈ· ˘ÂÚ‚ÔÏÈ΋ ¤ÎÎÚÈÛË Î·Ù¯ÔÏ·ÌÈÓÒÓ Ú¤ÂÈ Ó· ‰È·‰Ú·Ì·Ù›˙ÂÈ ‚·ÛÈÎfi ÚfiÏÔ
ÛÙËÓ ·ıÔÁ¤ÓÂÈ· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘. ™ÙȘ ÂÚÈÛÛfiÙÂÚ˜
ÛÂÈÚ¤˜ ·ÛıÂÓÒÓ ·Ó·Ê¤ÚÂÙ·È ÌÂÁ·Ï‡ÙÂÚË Â›ÙˆÛË
ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ÛÙȘ Á˘Ó·›Î˜ Î·È ÛÙÔ˘˜ ÈÔ ËÏÈÎȈ̤ÓÔ˘˜ Ì ÙȘ ÌÂÙÂÌÌËÓÔ·˘ÛȷΤ˜ Á˘Ó·›Î˜ Ó· ·Ô-
ÙÂÏÔ‡Ó ÙÔ 90% ÙˆÓ ÂÚÈÙÒÛÂˆÓ ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜
ÌÂϤÙ˜.11-13 ¶·ÚfiÏ· ·˘Ù¿, ˘¿Ú¯Ô˘Ó οÔȘ ÂÍ·ÈÚ¤ÛÂȘ ηıÒ˜ ÔÈ ÚÔÂÌÌËÓÔ·˘ÛȷΤ˜ Á˘Ó·›Î˜ ÂÌÊ·Ó›˙Ô˘Ó Û ÌÂÁ·Ï‡ÙÂÚË Û˘¯ÓfiÙËÙ· ÙËÓ ÌÔÚÊ‹ Ù˘
ÓfiÛÔ˘ Ô˘ ·Ê‹ÓÂÈ ¿ıÈÎÙË ÙËÓ ÎÔÚ˘Ê‹ Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜14 ÂÓÒ ÔÈ ¿ÓÙÚ˜ ÂÌÊ·Ó›˙Ô˘Ó Û˘¯ÓfiÙÂÚ· ÙÔ
Û‡Ó‰ÚÔÌÔ ÌÂÙ¿ ·fi Ê˘ÛÈÎfi Î·È fi¯È „˘¯ÈÎfi ÛÙÚÂÛÛÔÁfiÓÔ ÂÚ¤ıÈÛÌ·.15 ∏ ·ÈÙ›· Ù˘ ÌÂÁ·Ï‡ÙÂÚ˘ Û˘¯ÓfiÙËÙ·˜ ÂÌÊ¿ÓÈÛ˘ ÛÙȘ Á˘Ó·›Î˜ ·Ú·Ì¤ÓÂÈ ¿ÁÓˆÛÙË ·Ó
Î·È Ë ¤ÏÏÂÈ„Ë ÔÈÛÙÚÔÁfiÓˆÓ ÛÙȘ ÌÂÙÂÌÌËÓÔ·˘ÛȷΤ˜ Á˘Ó·›Î˜ Ê·›ÓÂÙ·È Ó· ·›˙ÂÈ Î¿ÔÈÔ ÚfiÏÔ ÛÙËÓ
·ıÔÁ¤ÓÂÈ· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘. ∏ ‡·ÚÍË Î¿ÔÈÔ˘ Û˘Ó·ÈÛıËÌ·ÙÈÎÔ‡ ÛÙÚÂÛÛÔÁfiÓÔ˘ ÂÚÂı›ÛÌ·ÙÔ˜ Ê·›ÓÂÙ·È
Ó· Â›Ó·È ÙÔ ÂÎÏ˘ÙÈÎfi ·›ÙÈÔ ÛÙ· 2/3 ÙˆÓ ÂÚÈÙÒÛˆÓ.
∞Ó Î·È Ù˘Èο Ë Ì˘Ôηډȷ΋ ‰˘ÛÏÂÈÙÔ˘ÚÁ›· ·ÎÔÏÔ˘ı› ¤Ó· Ô͇ „˘¯ÔÏÔÁÈÎfi ÛÙÚÂÛÛÔÁfiÓÔ ÂÚ¤ıÈÛÌ·
(·ÚÔÛ‰fiÎËÙÔ˜ ı¿Ó·ÙÔ˜ ÛÙÂÓÔ‡ Û˘ÁÁÂÓÔ‡˜, ·ÓÙÈ·Ú¿ıÂÛË Ì οÔÈÔ ÚfiÛˆÔ, Êfi‚Ô˜ ÚÈÓ ·fi οÔÈ· Â¤Ì‚·ÛË ÎÏ.), ¤Ó· Ê˘ÛÈÎfi ÛÙÚÂÛÛÔÁfiÓÔ ÂÚ¤ıÈÛÌ· (.¯. Ó¢ÌÔÓÈ΋ ÓfiÛÔ˜, Û‹„Ë, ÙÚ·‡Ì· ‹ ÎÚ·ÓÈÔÂÁÎÂÊ·ÏÈ΋ οΈÛË) ¤¯ÂÈ ÙȘ ›‰È˜ Èı·ÓfiÙËÙ˜
Ó· Â›Ó·È ÙÔ ÂÎÏ˘ÙÈÎfi ·›ÙÈÔ. ∏ ∫·˘Î¿ÛÈ· Ê˘Ï‹ ›ӷÈ
ÈÔ Â˘¿ÏˆÙË ÛÙÔ Û˘Ó·ÈÛıËÌ·ÙÈÎfi stress ·fi fiÙÈ ÔÈ
∞ÛÈ¿Ù˜.16 ∂›Ó·È fï˜ ¯·Ú·ÎÙËÚÈÛÙÈÎfi fiÙÈ ÛÙÔ 1/3
ÙˆÓ ÂÚÈÙÒÛÂˆÓ ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ‰ÂÓ ·ÓȯÓ‡ÂÙ·È
ÛÙÔ ÈÛÙÔÚÈÎfi Ë ‡·ÚÍË ÛÙÚÂÛÛÔÁfiÓÔ˘ ÂÚÂı›ÛÌ·ÙÔ˜
Î·È Î·Ù¿ Û˘Ó¤ÂÈ· Ë ·Ô˘Û›· Û·ÊÔ‡˜ ÂÎÏ˘ÙÈÎÔ‡ ·ÈÙ›Ô˘ ‰ÂÓ ·ÔÎÏ›ÂÈ ÙË ‰È¿ÁÓˆÛË ÙÔ˘ TTC.
¶·ıÔÁ¤ÓÂÈ·
√È ·ıÔÁÂÓÂÙÈÎÔ› Ì˯·ÓÈÛÌÔ› ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ·Ú·Ì¤ÓÔ˘Ó ÂÓ ÔÏÏÔ›˜ ¿ÁÓˆÛÙÔÈ. Œ¯Ô˘Ó ηٿ ηÈÚÔ‡˜
ÚÔÙ·ı› ‰È¿ÊÔÚ˜ ıˆڛ˜. ∏ ÌÂÁ¿ÏË ¤ÎÎÚÈÛË Î·Ù¯ÔÏ·ÌÈÓÒÓ Û·ÊÒ˜ ‰È·‰Ú·Ì·Ù›˙ÂÈ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ
·ÏÏ¿ Ë ·ÎÚÈ‚‹˜ ‰Ú¿ÛË Ù˘ ¿Óˆ ÛÙÔ Ì˘ÔοډÈÔ ‰ÂÓ
¤¯ÂÈ ·ÔÛ·ÊËÓÈÛÙ›. √È Ibanez Î·È Û˘Ó. ˘ÔÛÙ‹ÚÈÍ·Ó
ÙËÓ ‡·ÚÍË ·ıËÚÔÛÎÏËÚ˘ÓÙÈ΋˜ ÓfiÛÔ˘ Ì ڋÍË Ͽη˜ Ô˘ Ô‰ËÁ› Û ÔÍ›· ÈÛ¯·ÈÌ›·.17 ŸÏÔÈ ÔÈ ·ÛıÂÓ›˜ Ô˘ ·ÚÔ˘ÛÈ¿ÛÙËÎ·Ó ·fi ÙÔ˘˜ Û˘ÁÎÂÎÚÈ̤ÓÔ˘˜
ÂÚ¢ÓËÙ¤˜ ·ÚÔ˘Û›·˙·Ó ·ÚfiÌÔÈ· ÌÔÚÊÔÏÔÁ›· ÙˆÓ
ÛÙÂÊ·ÓÈ·›ˆÓ ·ÁÁ›ˆÓ Ì ÌÂÁ¿ÏÔ˘ Ì‹ÎÔ˘˜ ÚfiÛıÈÔ
ηÙÈfiÓÙ· ÎÏ¿‰Ô (LAD) Ô˘ ·Ó·Î¿ÌÙÂÈ Á‡Úˆ ·fi
ÙËÓ ÎÔÚ˘Ê‹ Ù˘ ηډȿ˜ ÂÍËÁÒÓÙ·˜ ¤ÙÛÈ Î·È ÙËÓ ·ÎÈÓËÛ›· Ù˘ ÎÔÚ˘Ê‹˜ Ô˘ ·Ú·ÙËÚÂ›Ù·È ÛÙÔ Û‡Ó‰ÚÔÌÔ.
¶·ÚfiÏ· ·˘Ù¿, Ë ·ÚÔ˘Û›· ¤ÛÙˆ Î·È ·ÚÔ‰È΋˜ Ì˘Ôηډȷ΋˜ ÈÛ¯·ÈÌ›·˜ ··ÈÙ› ÙËÓ ‡·ÚÍË ıÚfiÌ‚Ô˘
ÂÓÙfi˜ ÙˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ·ÁÁ›ˆÓ οÙÈ Ô˘ ÔÙ¤ ‰ÂÓ
¤¯ÂÈ ‚ÚÂı› Û ·ÛıÂÓ›˜ Ì TTC. ∂›Û˘, Ë ·ÚÔ˘Û›·
ÌÂÁ¿ÏÔ˘ Ì‹ÎÔ˘˜ LAD ‰ÂÓ ¤¯ÂÈ ÂÚÈÁÚ·Ê› ·fi ¿ÏÏÔ˘˜ ÂÚ¢ÓËÙ¤˜.
.
™‡Ìʈӷ Ì ÌÈ· ¿ÏÏË ıˆڛ· ÚÔÙ›ÓÂÙ·È Ô
Û·ÛÌfi˜ ÙˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ˆ˜ ÂÎÏ˘ÙÈÎfi ·›ÙÈÔ ÙÔ˘
Û˘Ó‰ÚfiÌÔ˘. √ Û·ÛÌfi˜ Ú¤ÂÈ Ó· Û˘Ì‚·›ÓÂÈ Ù·˘Ùfi¯ÚÔÓ· Û ÔÏÏ¿ ·ÁÁ›· ÚÔÎÂÈ̤ÓÔ˘ Ó· ‰ÈηÈÔÏÔÁËıÔ‡Ó ÔÈ ‰È·ÊÔÚÂÙÈΤ˜ ÂÓÙÔ›ÛÂȘ ÙˆÓ ˘ÔÎÈÓËÛÈÒÓ
ÛÙ· ÙÔȯÒÌ·Ù· Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜. ¶Ú¿ÁÌ·ÙÈ, οÔÈÔÈ ÂÚ¢ÓËÙ¤˜ ηÙfiÚıˆÛ·Ó Ó· ÚÔηϤÛÔ˘Ó Û·ÛÌfi Û ÔÏÏ¿ ·ÁÁ›· Ù·˘Ùfi¯ÚÔÓ· Û ·ÛıÂÓ›˜ ÌÂ
TTC11,18 ÂÓÒ ·ÓÙ›ıÂÙ· ¿ÏÏÔÈ ·¤Ù˘¯·Ó.19,20 ∂ÈϤÔÓ, Ë Î·Ù¿ ÚÔ˘Ù›Ó· ¯ÔÚ‹ÁËÛË ÓÈÙÚˆ‰ÒÓ ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ô˘ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È Ì ÔÈÛıÔÛÙÂÚÓÈÎfi ¿ÏÁÔ˜
οÓÂÈ ÈÔ ‰‡ÛÎÔÏË ÙËÓ ‰ÈÂÚ‡ÓËÛË ÙÔ˘ Û˘ÁÎÂÎÚÈ̤ÓÔ˘ Ì˯·ÓÈÛÌÔ‡. ø˜ ¿ÏÏË Èı·Ó‹ ·ÈÙ›· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ·Ó·Ê¤ÚÂÙ·È Ë ÌÈÎÚÔ·ÁÁÂȷ΋ ‰˘ÛÏÂÈÙÔ˘ÚÁ›· ηÈ
Ô Û·ÛÌfi˜ ÙˆÓ ÌÈÎÚÒÓ ·ÁÁ›ˆÓ. √È Elsber Î·È Û˘Ó.21
·Ó·Ê¤ÚÔ˘Ó ·ÓÒÌ·ÏË ·ÈÌ¿ÙˆÛË Î·Ù¿ TIMI (¤Ó·˜ ·ÁÁÂÈÔÁÚ·ÊÈÎfi˜ ‰Â›ÎÙ˘ ·ÈÌ¿ÙˆÛ˘ ÙÔ˘ Ì˘Ôηډ›Ô˘)
ÛÙÔ 69% ÙˆÓ ·ÛıÂÓÒÓ Ì TTC. ∂ÈÚfiÛıÂÙ·, ÔÈ
Sadamatsu Î·È Û˘Ó.22 ¤‰ÂÈÍ·Ó ÌÂȈ̤ÓË ÛÙÂÊ·ÓÈ·›·
Âʉڛ· ÚÔ‹˜ ¯ÚËÛÈÌÔÔÈÒÓÙ·˜ ¤Ó· ÂȉÈÎfi Û‡ÚÌ·
ηıÔ‰ËÁÔ‡ÌÂÓÔ Ì Doppler ÛÙÔ˘˜ ·ÛıÂÓ›˜ ÙÔ˘˜ ÌÂ
∆∆C. ∞ÓÙ›ıÂÙ·, ÔÈ Yoshida Î·È Û˘Ó.23 ‚Ú‹Î·Ó ÌfiÓÔ
‹ÈÔ ÂÚÈÔÚÈÛÌfi ÛÙËÓ ·ÈÌ¿ÙˆÛË Î·Ù¿ ÙË ‰ÔÎÈÌ·Û›·
Ì ÛÈÓıËÚÔÁÚ¿ÊËÌ· Ì˘Ôηډ›Ô˘ Ì Thallium 201
ÛÙÔ˘˜ ·ÛıÂÓ›˜ ÙÔ˘˜ Ô˘ ·ÚÔ˘Û›·˙·Ó ÙÔ Û‡Ó‰ÚÔÌÔ
ÂÓÒ ‹Ù·Ó Û·ÊÒ˜ ÌÂȈ̤ÓË Ë ÚfiÛÏË„Ë Ù˘ F-8 ÊÏÔ˘ÔÚÔ‰ÂÛÔ͢ÁÏ˘Îfi˙˘ ·fi ÙË ÎÔÚ˘Ê‹ Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜ ÁÂÁÔÓfi˜ Ô˘ ‰Â›¯ÓÂÈ ÌÂÙ·‚ÔÏÈÎfi ¤ÏÏÂÈÌÌ·
·Ú¿ ¤ÏÏÂÈÌÌ· ·ÈÌ¿ÙˆÛ˘. ŒÙÛÈ, ·Ú·Ì¤ÓÂÈ ·‰È¢ÎÚ›ÓÈÛÙÔ ·Ó Ë ‰È·Ù·Ú·¯‹ ÙˆÓ ÌÈÎÚÒÓ ·ÁÁ›ˆÓ ·›˙ÂÈ
‚·ÛÈÎfi ÚfiÏÔ ÛÙËÓ ·ıÔÁ¤ÓÂÈ· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ‹ ·Ó
·ÔÙÂÏ› Û˘ÓÔ‰fi ‡ÚËÌ· ÌÈ·˜ ÈÔ ÂÎÙÂٷ̤Ó˘ Ì˘Ôηډȷ΋˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›·˜.
∏ ˘fiıÂÛË Ù˘ ÔÍ›·˜ Ì˘Ôηډ›Ùȉ·˜ ˆ˜ ·›ÙÈÔ
Ù˘ Ì˘Ôηډȷ΋˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›·˜ ‰ÂÓ ÂȂ‚·ÈÒıËΠ·fi ÌÂϤÙ˜ Ô˘ ‰ÈÂÓÂÚÁ‹ıËÎ·Ó Ì˘ÔηډȷΤ˜
‚ÈÔ„›Â˜.24,25 ∂Ó‰ÂÈÎÙÈΤ˜ Ù˘ ·¢ı›·˜ ÙÔÍÈ΋˜ ‰Ú¿Û˘ ÙˆÓ Î·Ù¯ÔÏ·ÌÈÓÒÓ Â›Ó·È ÔÈ ·Ú·ÙËÚÔ‡ÌÂÓ˜
‚Ï¿‚˜ Û ÈÛÙÈÎfi Â›‰Ô. ∏ ÚÒÙË ·Ó·ÊÔÚ¿ ÁÈ· ·˘ÍË̤ӷ Â›‰· ηÙ¯ÔÏ·ÌÈÓÒÓ ÛÙÔ Ï¿ÛÌ· ·ÛıÂÓÒÓ Ì TTC ‹Ù·Ó ·fi ÙÔ˘˜ Wittstein Î·È Û˘Ó24 ÂÓÒ
Û ÌÈ· ÚfiÛÊ·ÙË ÌÂϤÙË ÂȂ‚·ÈÒıËÎ·Ó Ù· Â˘Ú‹Ì·Ù· ·˘Ù¿ ηıÒ˜ ‰È·ÈÛÙÒıËΠ·˘ÍË̤ÓË ÙÔÈ΋
·ÂÏ¢ı¤ÚˆÛË Î·Ù¯ÔÏ·ÌÈÓÒÓ ·fi ‰Â›ÁÌ·Ù· ·›Ì·ÙÔ˜ Ô˘ ÂÏ‹ÊıËÛ·Ó ·fi ÙËÓ ·ÔÚÙÈ΋ Ú›˙· Î·È ÙÔÓ
ÛÙÂÊ·ÓÈ·›Ô ÎfiÏÔ.26 ™Â ÌÂϤÙ˜ Ì ÂÈÚ·Ì·Ùfi˙ˆ·
·Ú·ÙËÚ‹ıËΠ·˘ÍË̤ÓË ˘ÎÓfiÙËÙ· ‚ – ·‰ÚÂÓÂÚÁÈÎÒÓ ˘Ô‰Ô¯¤ˆÓ ÛÙËÓ ÎÔÚ˘Ê‹ Ù˘ ηډȿ˜.27 ∞Ó Î¿ÙÈ
Ù¤ÙÔÈÔ ÈÛ¯‡ÂÈ Î·È ÁÈ· ÙËÓ ·ÓıÚÒÈÓË Î·Ú‰È¿, ÌÔÚ›
οÏÏÈÛÙ· Ó· ÂÍËÁ‹ÛÂÈ ÙËÓ ·˘ÍË̤ÓË Â˘·ÈÛıËÛ›· Ù˘
ÎÔÚ˘Ê‹˜ Ù˘ ηډȿ˜ ÛÙËÓ ¿ÌÂÛË ÙÔÍÈ΋ Â›‰Ú·ÛË
ÙˆÓ Î·Ù¯ÔÏ·ÌÈÓÒÓ, οÙÈ Ô˘ ̤ÓÂÈ fï˜ Ó· ·Ô‰Âȯı›. ∞fi ÙÔ˘˜ Lyon Î·È Û˘Ó28 ÚÔÙ¿ıËΠ¤Ó· ÌÔÓÙ¤ÏÔ Ô˘ ÂÚÈÂÏ¿Ì‚·Ó ÌÈ· ·ÏÏ·Á‹ ÛÙËÓ ÂÓ‰Ô΢ÙÙ¿ÚÈ·
ÌÂÙ¿‰ÔÛË ÙÔ˘ ÂÚÂı›ÛÌ·ÙÔ˜ ÛÙ· Ì˘Ôηډȷο ·ÙÙ·Ú· ·fi ÙȘ ÚˆÙ½Ó˜ Gs ÛÙȘ ·ÓÙ›ÛÙÔȯ˜ Gi ̤ۈ
ÙˆÓ ‚2 ·‰ÚÂÓÂÚÁÈÎÒÓ ˘Ô‰Ô¯¤ˆÓ, ÚÔηÏÒÓÙ·˜ ¤ÙÛÈ
ÌÈ· ·ÚÔ‰È΋ ·ÚÓËÙÈ΋ ÈÓfiÙÚÔË ‰Ú¿ÛË. ∞˘Ù‹ Ë ˘fiıÂÛË ˆÛÙfiÛÔ ‰ÂÓ ¤¯ÂÈ ÂȂ‚·Èˆı› ·ÎfiÌË. ŒÓ·˜
¿ÏÏÔ˜ ·ıÔÁÂÓÂÙÈÎfi˜ Ì˯·ÓÈÛÌfi˜ Ô˘ ÂÌϤÎÂÙ·È
ÛÙËÓ ÂÌÊ¿ÓÈÛË ÙÔ˘ TTC Â›Ó·È Ë ÂÌÊ¿ÓÈÛË ·ÚÔ‰È΋˜
·fiÊڷ͢ ÙÔ˘ ¯ÒÚÔ˘ ÂÍfi‰Ô˘ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜.29 ™‡Ìʈӷ Ì ÙËÓ ¿Ô„Ë ·˘Ù‹ ËÏÈÎȈ̤Ó˜ Á˘Ó·›Î˜ Ô˘ Û˘¯Ó¿ ¤¯Ô˘Ó ÛÈÁÌÔÂȉ¤˜ ÌÂÛÔÎÔÈÏÈ·Îfi
‰È¿ÊÚ·ÁÌ· ÌÔÚ› Ó· ÂÌÊ·Ó›ÛÔ˘Ó ÛÔ‚·ÚÔ‡ ‚·ıÌÔ‡
·fiÊÚ·ÍË Î¿Ùˆ ·fi ÙËÓ Â›‰Ú·ÛË ·˘ÍËÌ¤ÓˆÓ ÂÈ¤‰ˆÓ ηÙ¯ÔÏ·ÌÈÓÒÓ, Ì ·ÔÙ¤ÏÂÛÌ· Ó· ÚÔηÏÂ›Ù·È ÈÛ¯·ÈÌ›· Ù˘ ÎÔÚ˘Ê‹˜ ÏfiÁˆ ·˘ÍË̤Ó˘ ÙÔȯˆÌ·ÙÈ΋˜ Ù¿Û˘. ∞Ó Î·È Î·Ù¿ ÙË ¯ÔÚ‹ÁËÛË ‰Ô‚Ô˘Ù·Ì›Ó˘
·Ó··Ú‹¯ıË ÛËÌ·ÓÙÈ΋ ÂÓ‰ÔÎÔÈÏÔÙÈ΋ ÎÏ›ÛË ›ÂÛ˘
Û οÔÈÔ˘˜ ·ÛıÂÓ›˜ Ì TTC, Ô Ì˯·ÓÈÛÌfi˜ ·˘Ùfi˜
‰ÂÓ ÌÔÚ› Ó· ÂÍËÁ‹ÛÂÈ ÙȘ ÏÈÁÔÛÙ¤˜ ·Ú·ÏÏ·Á¤˜ Ù˘
ÓfiÛÔ˘ ÛÙȘ Ôԛ˜ ‰ÂÓ ·Ú·ÙËÚÂ›Ù·È ÚÔÛ‚ÔÏ‹ Ù˘
ÎÔÚ˘Ê‹˜. ªÔÏ·Ù·‡Ù·, ÌÔÚ› Ó· ·ÓÙÈÚÔÛˆ‡ÂÈ
ÌÈ· Û˘Ó˘¿Ú¯Ô˘Û· ·ÈÙ›· Û οÔÈ· ÂÚÈÛÙ·ÙÈο.
ŒÓ·˜ ÙÂÏÂ˘Ù·›Ô˜ Ì˯·ÓÈÛÌfi˜ ¤¯ÂÈ ÂÚÈÁÚ·Ê› ÛÂ
·ÛıÂÓ›˜ Ì ˘·Ú·¯ÓÔÂȉ‹ ·ÈÌÔÚÚ·Á›· fiÔ˘ ¤¯ÂÈ
·Ú·ÙËÚËı› ‰˘ÛÏÂÈÙÔ˘ÚÁ›· Ù˘ ÎÔÚ˘Ê‹˜ Ù˘ ηډȿ˜ ·ÚfiÌÔÈ· Ì ·˘Ù‹ ÙˆÓ ·ÛıÂÓÒÓ Ì TTC. ∆Ô ÂӉȷʤÚÔÓ ÛËÌÂ›Ô Â›Ó·È ˆ˜ ¤¯ÂÈ Û˘Û¯ÂÙÈÛı› Ì ڋÍË
·Ó¢ڢÛÌ¿ÙˆÓ Ô˘ ÂÓÙÔ›˙ÔÓÙ·È ÛÙÔ ‹ÌÈÛ˘ ÙÔ˘ ÚfiÛıÈÔ˘ ÙÌ‹Ì·ÙÔ˜ ÙÔ˘ ·ÎÏÔ˘ ÙÔ˘ Willis. ∞˘Ù¿ Ù· ·Ó¢ڇÛÌ·Ù· ÂÓÙÔ›˙ÔÓÙ·È ¿Óˆ ·fi ÙËÓ ·Ì˘Á‰·Ï‹ ηÈ
ÙÔ ÊÏÔÈfi Ù˘ ‰ÂÍÈ¿˜ ÓËÛȉȷ΋˜ ‰ÂÍ·ÌÂÓ‹˜, Ô˘ ÂϤÁ¯Ô˘Ó ÙË Û˘Ì·ıËÙÈ΋ ‰Ú·ÛÙËÚÈfiÙËÙ· Ù˘ ηډȿ˜.30
∞Ó Î·È ·˘Ù‹ Ë ÙÂÏÂ˘Ù·›· ˘fiıÂÛË ÚÔÛʤÚÂÈ ÙfiÛÔ
·Ó·ÙÔÌÈ΋ fiÛÔ Î·È ÏÂÈÙÔ˘ÚÁÈ΋ ÂÍ‹ÁËÛË Ù˘ Ì˘Ôηډȷ΋˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›·˜ ·fi stress, ‰ÂÓ ˘¿Ú¯Ô˘Ó
ÚÔ˜ ÙÔ ·ÚfiÓ ÎÏÈÓÈο ‹ ÂÈÚ·Ì·ÙÈο ‰Â‰Ô̤ӷ ÁÈ·
Ó· ÙËÓ ÂȂ‚·ÈÒÛÔ˘Ó.
KÏÈÓÈο ÷ڷÎÙËÚÈÛÙÈο
∏ ÎÏÈÓÈο ÂÈÎfiÓ· ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ Â›Ó·È Û˘¯Ó¿ ‰˘Û‰È¿ÎÚÈÙË ·fi ·˘Ù‹ ÂÓfi˜ ÔͤԘ ÛÙÂÊ·ÓÈ·›Ô˘ Û˘Ó‰ÚfiÌÔ˘. ∆Ô ÛÙËı·Á¯ÈÎfi ¿ÏÁÔ˜ ˘¿Ú¯ÂÈ Û¯Â‰fiÓ ¿ÓÙ·,
ÛÙÔ 100% ÙˆÓ ÂÚÈÛÙ·ÙÈÎÒÓ ÛÙȘ ÂÚÈÛÛfiÙÂÚ˜ ÛÂÈÚ¤˜. ∂Ó›ÔÙÂ Û˘Óԉ‡ÂÙ·È ·fi ‰‡ÛÓÔÈ·, ·›ÛıËÌ·
·ÏÌÒÓ, ÂÊ›‰ÚˆÛË, Ó·˘Ù›· ‹ Û˘ÁÎÔ‹. §ÈÁfiÙÂÚÔ Û˘¯Ó¿ ÂÌÊ·Ó›˙ÂÙ·È ·ÈÌÔ‰˘Ó·ÌÈ΋ ·ÛÙ¿ıÂÈ· Ì ˘fiÙ·ÛË ‹ ·ÎfiÌË Î·È Î·Ú‰ÈÔÁÂÓ‹ ηٷÏËÍ›·, ÔfiÙÂ
··ÈÙÂ›Ù·È Ì˯·ÓÈ΋ ˘ÔÛÙ‹ÚÈÍË Ù˘ ΢ÎÏÔÊÔÚ›·˜
.
.
Î·È Ù˘ ·Ó·ÓÔ‹˜.24 ∆· ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈο Â˘Ú‹Ì·Ù· Û˘Ó‹ıˆ˜ ÌÈÌÔ‡ÓÙ·È ·˘Ù¿ ÙÔ˘ ÔͤԘ ÂÌÊÚ¿ÁÌ·ÙÔ˜ Ì ‹ ¯ˆÚ›˜ ·Ó¿Û·ÛË ÙÔ˘ ST (∂ÈÎfiÓ· 2). √È
Sharkey Î·È Û˘Ó31 ÌÂϤÙËÛ·Ó ÂÈÛٷ̤ӈ˜ Ù· ∏∫°
59 ·ÛıÂÓÒÓ Ì TTC. ∫·Ù¿ ÙËÓ ÚÔÛ¤ÏÂ˘Û‹ ÙÔ˘˜ ÙÔ
56% ÙˆÓ ·ÛıÂÓÒÓ ÂÌÊ¿ÓÈÛ·Ó ·Ó¿Û·ÛË ÙÔ˘ ST, ÙÔ
17% ÂÌÊ¿ÓÈÛ ·Ó·ÛÙÚÔÊ‹ ÙˆÓ T Î·È ÙÔ 10% ·̷ٷ
Q ‹ Ùˆ¯‹ ÚfiÔ‰Ô ÙˆÓ R. ∞ÍÈÔÛËÌ›ˆÙÔ Â›Ó·È ÙÔ ÁÂÁÔÓfi˜ ˆ˜ ÙÔ ˘fiÏÔÈÔ 17% ÙˆÓ ·ÛıÂÓÒÓ Â›¯Â ›ÙÂ
ÌË ÂȉÈΤ˜ ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈΤ˜ ·ÏÏ·Á¤˜ ›Ù η̛· ·ÏÏ·Á‹. ∫·Ù¿ ÙË ‰È¿ÚÎÂÈ· Ù˘ Ê¿Û˘ ·Ó¿ÚÚˆÛ˘ ÙÔ ÈÔ Û˘¯Ó¿ ·Ú·ÙËÚÔ‡ÌÂÓÔ ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈÎfi ¯·Ú·ÎÙËÚÈÛÙÈÎfi ‹Ù·Ó Ë ·Ó·ÛÙÚÔÊ‹ ‹ Ë ÂÚ·ÈÙ¤Úˆ ·ÚÓËÙÈÎÔÔ›ËÛË ÙˆÓ Î˘Ì¿ÙˆÓ ∆ (΢ڛˆ˜
ÛÙȘ ··ÁˆÁ¤˜ V2 ¤ˆ˜ V6). ™ÙËÓ ›‰È· ÌÂϤÙË, ÙÔ Û˘ÓÔÏÈÎfi ¿ıÚÔÈÛÌ· Ù˘ ·Ó¿Û·Û˘ ÙÔ˘ ST ‹Ù·Ó ÌÈÎÚfiÙÂÚÔ Û ۯ¤ÛË Ì ÂΛÓÔ ÙˆÓ ·ÛıÂÓÒÓ Ì ·fiÊÚ·ÍË
ÙÔ˘ LAD. øÛÙfiÛÔ, Ë ÛËÌ·ÓÙÈ΋ ·ÏÏËÏÔÂÈÎ¿Ï˘„Ë
ÌÂٷ͇ ÙˆÓ ÚÔ·Ó·ÊÂÚıÂÈÛÒÓ ÙÈÌÒÓ ·ÔÎÏ›ÂÈ ÙË
¯Ú‹ÛË ÙˆÓ ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈÎÒÓ ·˘ÙÒÓ ·ÏÏ·ÁÒÓ
ˆ˜ ‰È·ÁÓˆÛÙÈÎfi ÂÚÁ·Ï›Ô. ∏ ·Ú¿Ù·ÛË ÙÔ˘ QTc ηÈ
Ë Â·ÓÂÌÊ¿ÓÈÛË ÙˆÓ Î˘Ì¿ÙˆÓ R ‹Ù·Ó Ù· ÈÔ ÎÔÈÓ¿
¯·Ú·ÎÙËÚÈÛÙÈο ηٿ ÙËÓ ÂͤÏÈÍË Ù˘ ÓfiÛÔ˘. ÕÏÏÔÈ
Û˘ÁÁÚ·Ê›˜ ¤¯Ô˘Ó ÂÚÈÁÚ¿„ÂÈ ˆ˜ ÔÈ ¿Û¯ÔÓÙ˜
·fi TTC ÂÌÊ·Ó›˙Ô˘Ó ‚·ı‡ÙÂÚ· ·ÚÓËÙÈο ·̷ٷ ∆
‹ ÈÔ ·Ú·ÙÂٷ̤ÓÔ QTc ‰È¿ÛÙËÌ· Û˘ÁÎÚÈÙÈο ÌÂ
ÙÔ˘˜ ¿Û¯ÔÓÙ˜ ·fi ÛÙÂÊ·ÓÈ·›· ÓfiÛÔ.32 ∏ ·Ô˘Û›·
ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈÎÒÓ ·ÏÏ·ÁÒÓ ‰›ÎËÓ Î·ÙfiÙÚÔ˘
ÛÙȘ ηÙÒÙÂÚ˜ ··ÁˆÁ¤˜ Î·È Ë ÙÈÌ‹ ÙÔ˘ ÎÏ¿ÛÌ·ÙÔ˜
Ù˘ ·Ó¿Û·Û˘ ÙÔ˘ ST ÛÙȘ ··ÁˆÁ¤˜ V4 – V6 ÚÔ˜
V1 – V3 ≥ 1, ¤¯Ô˘Ó Â›Û˘ ıˆÚËı› ÂȉÈο ¯·Ú·ÎÙËÚÈÛÙÈο ÁÈ· ÙË ‰È¿ÁÓˆÛË TTC33. øÛÙfiÛÔ, ·ÎfiÌË
Î·È ·˘Ù¿ Ù· ¯·Ú·ÎÙËÚÈÛÙÈο Â›Ó·È Ôχ ‰˘Û‰È¿ÎÚÈÙ·
ÁÈ· Ó· ‚ÔËı‹ÛÔ˘Ó ÛÙËÓ Î·ıËÌÂÚÈÓ‹ ÎÏÈÓÈ΋ Ú¿ÍË
A
ÛÙË ‰È·ÊÔÚÈ΋ ‰È¿ÁÓˆÛË ÙÔ˘ TTC ·fi ¤Ó· Ô͇ ÛÙÂÊ·ÓÈ·›Ô ÂÂÈÛfi‰ÈÔ. √È ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈΤ˜ ·ÏÏ·Á¤˜ Ô˘ ÂÌÊ·Ó›˙ÔÓÙ·È ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ì TTC ÌÂ
ÙËÓ ¿ÚÔ‰Ô ÙÔ˘ ¯ÚfiÓÔ˘ ÌÔÈ¿˙Ô˘Ó ·ÚfiÌÔȘ Ì ·˘Ù¤˜ Ô˘ ·Ú·ÙËÚÔ‡ÓÙ·È ÛÙÔ˘˜ ·ÛıÂÓ›˜ Ì Ô͇ ¤ÌÊÚ·ÁÌ· ÙÔ˘ Ì˘Ôηډ›Ô˘ Ì ·Ó¿Û·ÛË ÙÔ˘ ST Ô˘
˘Ô‚¿ÏÏÔÓÙ·È Û ÚÒÈÌË Â·Ó·ÈÌ¿ÙˆÛË Ì ÙËÓ ·Ó·ÛÙÚÔÊ‹ ÙˆÓ Î˘Ì¿ÙˆÓ ∆ Ó· ‰È·ÙËÚÂ›Ù·È ÁÈ· ¯ÚÔÓÈÎfi
‰È¿ÛÙËÌ· ÙÔ˘Ï¿¯ÈÛÙÔÓ 2 – 3 ‚‰ÔÌ¿‰ˆÓ.32
™˘¯Ó¿, ·Ú·ÙËÚÂ›Ù·È ÌÈÎÚ‹ ·‡ÍËÛË Î·Ú‰È·ÎÒÓ
ÂÓ˙‡ÌˆÓ, ÂÓ‰ÂÈÎÙÈ΋ ̤ÙÚÈ·˜ ¤ÎÙ·Û˘ Ì˘Ôηډȷ΋˜
‚Ï¿‚˘. ∞fi ÙËÓ ¿ÏÏË ÌÂÚÈ¿, ÌÂϤÙ˜ ηډȷ΋˜
·ÂÈÎfiÓÈÛ˘ ·ÔηχÙÔ˘Ó ÂÎÙÂٷ̤ÓË ·ÎÈÓËÛ›· ‹
˘ÔÎÈÓËÛ›· Ù˘ ÎÔÚ˘Ê‹˜ ‹ ÙÔ˘ ̤ÛÔ˘ ÌÂÛÔÎÔÈÏÈ·ÎÔ‡
‰È·ÊÚ¿ÁÌ·ÙÔ˜, Â˘Ú‹Ì·Ù· ÌË Û˘Ì‚·Ù¿ Ì ÙËÓ ÌÈÎÚ‹
·‡ÍËÛË ÙˆÓ Î·Ú‰È·ÎÒÓ ÂÓ˙‡ÌˆÓ. ∞˘Ù¤˜ ÔÈ ‰È·Ù·Ú·¯¤˜ ÎÈÓËÙÈÎfiÙËÙ·˜ ÙÔ˘ Ì˘Ôηډ›Ô˘ ÂÎÙ›ÓÔÓÙ·È ¤Ú·Ó Ù˘ ¤ÎÙ·Û˘ ηٷÓÔÌ‹˜ ÌÈ·˜ ÛÙÂÊ·ÓÈ·›·˜ ·ÚÙËÚ›·˜ ˘Ô‰ËÏÒÓÔÓÙ·˜ ¤ÙÛÈ ˆ˜ Ô Èı·Ófi˜ Ì˯·ÓÈÛÌfi˜
Ù˘ ÔÍ›·˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›·˜ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ Â›Ó·È Ë ·ÔÏËÍ›· (stunning) ÙÔ˘ Ì˘Ôηډ›Ô˘ ·Ú¿ Ë
Ó¤ÎÚˆÛË ·˘ÙÔ‡. ¶Ú¤ÂÈ Ó· ÛËÌÂȈı› ˆ˜ ¤Ó· ÌÈÎÚfi ÔÛÔÛÙfi ·ÛıÂÓÒÓ ‰ÂÓ ¤¯Ô˘Ó ·˘ÍË̤ӷ Ì˘Ôηډȷο ¤Ó˙˘Ì·, ÁÂÁÔÓfi˜ Ô˘ ÛËÌ·›ÓÂÈ ˆ˜ Ë ·Ô˘Û›·
·˘ÍËÌ¤ÓˆÓ Ì˘ÔηډȷÎÒÓ ÂÓ˙‡ÌˆÓ ‰ÂÓ ·ÔÎÏ›ÂÈ
ÙË ‰È¿ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘.
∏ Ù˘È΋ ÂÈÎfiÓ· “Tako – tsubo” Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜ ÌÔÚ› Ó· ·ÂÈÎÔÓÈÛı› Ì ˘ÂÚ˯ÔηډÈÔÁÚ¿ÊËÌ·, ÎÔÈÏÈÔÁÚ·Ê›· Ì ÛÎÈ·ÁÚ·ÊÈÎfi (∂ÈÎfiÓ· 3)
‹ ·ÂÈÎfiÓÈÛË Ì·ÁÓËÙÈÎÔ‡ Û˘ÓÙÔÓÈÛÌÔ‡ (MRI) (∂ÈÎfiÓ· 4). ∏ ÙÂÏÂ˘Ù·›· ÂͤٷÛË (MRI) Ì ¯Ú‹ÛË Á·‰ÔÏÈÓ›Ô˘, fiÙ·Ó Â›Ó·È ‰È·ı¤ÛÈÌË, ÌÔÚ› Ó· Â›Ó·È Ôχ
¯Ú‹ÛÈÌË Î·ıÒ˜ ·Ó·‰ÂÈÎÓ‡ÂÈ ÙËÓ ·Ô˘Û›· Ì˘Ôηډȷ΋˜ Ó¤ÎÚˆÛ˘ Ì ÂÈÎfiÓ˜ ηı˘ÛÙÂÚË̤Ó˘ Ï‹„˘
B
∂ÈÎfiÓ· 2. ∞Ó¿Û·ÛË ÙÔ˘ ST ÛÙȘ ··ÁˆÁ¤˜ V2 – V6 (‚¤ÏË) ηٿ ÙËÓ ÚÔۤϢÛË (A) ·ÎÔÏÔ˘ıÔ‡ÌÂÓ· ·fi ·Ó·ÛÙÚÔÊ‹ ÙˆÓ Î˘Ì¿ÙˆÓ T
ÛÙȘ ›‰È˜ ··ÁˆÁ¤˜ (‚¤ÏË) 2 Ë̤Ú˜ ·ÚÁfiÙÂÚ· (B) Û ·ÛıÂÓ‹ Ì TTC (‰È΋ Ì·˜ ÂÚ›ÙˆÛË).
A
B
∂ÈÎfiÓ· 3. ∫ÔÈÏÈÔÁÚ·Ê›· ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ Ô˘ ‰Â›¯ÓÂÈ ‰˘ÛÎÈÓËÛ›· Ù˘ ÎÔÚ˘Ê‹˜ (ballooning) ηٿ ÙË Û˘ÛÙÔÏ‹
(A) Î·È Ê˘ÛÈÔÏÔÁÈ΋ Û˘ÛÙÔÏÈ΋ ÏÂÈÙÔ˘ÚÁ›· ÌÂÙ¿ ÙËÓ ·ÔηٿÛÙ·ÛË (B) Û ·ÛıÂÓ‹ Ì TTC (Mohamed HA.
Libyan J Med 2007; 2: 51-55, ·Ó·Ù‡ˆÛË Î·ÙfiÈÓ ¿‰ÂÈ·˜).
A
B
∂ÈÎfiÓ· 4. ∞ÂÈÎfiÓÈÛË Ì ̷ÁÓËÙÈÎfi Û˘ÓÙÔÓÈÛÌfi (MRI) Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ ÛÙËÓ ÙÂÏԉȷÛÙÔÏ‹ (A) Î·È ÛÙËÓ ÙÂÏÔÛ˘ÛÙÔÏ‹ (B) Û ·ÛıÂÓ‹ Ì TTC (‰È΋ Ì·˜ ÂÚ›ÙˆÛË).
.
Ì ÂÓ›Û¯˘ÛË Û‹Ì·ÙÔ˜ (late enhancement images).
¶ÔÏϤ˜ ÚfiÛÊ·Ù˜ ‰ËÌÔÛȇÛÂȘ ÌÂÌÔÓˆÌ¤ÓˆÓ ÂÚÈÛÙ·ÙÈÎÒÓ ‹ ÌÈÎÚÒÓ ÛÂÈÚÒÓ ÙÔÓ›˙Ô˘Ó ÙÔ ÛËÌ·ÓÙÈÎfi
ÚfiÏÔ Ù˘ MRI ηډȿ˜ ÛÙË ‰È¿ÁÓˆÛË ·ÛıÂÓÒÓ ÌÂ
ÛÙËı¿Á¯Ë Î·È Ê˘ÛÈÔÏÔÁÈο ÛÙÂÊ·ÓÈ·›· ·ÁÁ›·.33-35
∂ÈÚfiÛıÂÙ·, ‰Â‰Ô̤Ó˘ Ù˘ ‰˘ÛÎÔÏ›·˜ ·ÍÈÔÏfiÁËÛ˘ Ù˘ ÌÔÚÊÔÏÔÁ›·˜ Î·È Ù˘ ÏÂÈÙÔ˘ÚÁÈÎfiÙËÙ·˜ Ù˘
‰ÂÍÈ¿˜ ÎÔÈÏ›·˜ ˘ÂÚ˯ÔηډÈÔÁÚ·ÊÈÎÒ˜, Ë MRI
ÌÔÈ¿˙ÂÈ Ó· ·ÔÙÂÏ› ÙÔ Î·Ï‡ÙÂÚÔ ÂÚÁ·ÏÂ›Ô ÁÈ· ÙË
‰È¿ÁÓˆÛË Ù˘ Ù˘¯fiÓ Û˘ÌÌÂÙÔ¯‹˜ Î·È Ù˘ ‰ÂÍÈ¿˜ ÎÔÈÏ›·˜ ÛÙÔ TCC. ∂›Ó·È ·ÍÈÔÛËÌ›ˆÙÔ ÙÔ ÁÂÁÔÓfi˜ ˆ˜ Ë
‰˘ÛÏÂÈÙÔ˘ÚÁ›· Ù˘ ‰ÂÍÈ¿˜ ÎÔÈÏ›·˜ ÂÓÒ ·Ú¯Èο ·Ó·ÊÂÚfiÙ·Ó ÌfiÓÔ Û ÌÂÌÔӈ̤ӷ ÂÚÈÛÙ·ÙÈο, Û ÈÔ
ÚfiÛÊ·Ù˜ ‰ËÌÔÛȇÛÂȘ ·ÔÙÂÏ› ÈÔ Û˘¯Ófi ‡ÚËÌ· (26 – 30% ÙˆÓ ·ÛıÂÓÒÓ).37,38 ∆¤ÏÔ˜, ÌÈ· ÈÔ Û¿ÓÈ· ηٿÛÙ·ÛË ·ÔÙÂÏ› Ë ÂÌÊ¿ÓÈÛË ˘ÂÚÎÈÓËÛ›·˜
Ù˘ ÎÔÚ˘Ê‹˜ ÛÂ Û˘Ó‰˘·ÛÌfi Ì ˘ÔÎÈÓËÛ›· ÙˆÓ ‚·ÛÈÎÒÓ ÙÌËÌ¿ÙˆÓ (ÙÔ ·ÔηÏÔ‡ÌÂÓÔ Î·È ·Ó¿ÛÙÚÔÊÔ
Tako – tsubo syndrome) Î·È ¤¯ÂÈ ÂÚÈÁÚ·Ê› ÚfiÛÊ·Ù· Û ·ÛıÂÓ›˜ ¿Û¯ÔÓÙ˜ ·fi ÛÔ‚·Ú¤˜ ÂÓ‰ÔÎÚ¿ÓȘ ÓfiÛÔ˘˜ ‹ ÎÚ›ÛÂȘ Ê·ÈÔ¯ÚˆÌÔ΢ÙÒÌ·ÙÔ˜.39,40
ŒÓ·˜ ·ÛıÂÓ‹˜ Ì TTC Û˘Ó‹ıˆ˜ ıˆÚÂ›Ù·È ·Ú¯Èο ¿Û¯ˆÓ ·fi Ô͇ ÛÙÂÊ·ÓÈ·›Ô Û‡Ó‰ÚÔÌÔ Î·È
·Ú·¤ÌÂÙ·È ÂÂÈÁfiÓÙˆ˜ ÛÙÔ ·ÈÌÔ‰˘Ó·ÌÈÎfi ÂÚÁ·ÛÙ‹ÚÈÔ ÁÈ· ÛÙÂÊ·ÓÈÔÁÚ·Ê›·. ∆Ô Ù˘ÈÎfi ‡ÚËÌ· Â›Ó·È Ë ·Ô˘Û›· ÛËÌ·ÓÙÈ΋˜ ÛÙ¤ÓˆÛ˘ ÙˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ·ÁÁ›ˆÓ Ô˘ Ó· ‰ÈηÈÔÏÔÁ› ÙÔ ÂÂÈÛfi‰ÈÔ.
øÛÙfiÛÔ, ÔÈ Ibanez et al41 Ì ÙË ¯Ú‹ÛË ÂÓ‰ÔÛÙÂÊ·ÓÈ·›Ô˘ ˘ÂÚ‹¯Ô˘ ÂÚȤÁÚ·„·Ó ÙËÓ ·ÚÔ˘Û›· ÚËÁÌ¤ÓˆÓ ·ıËÚÔÛÎÏËÚ˘ÓÙÈÎÒÓ Ï·ÎÒÓ Û οÔÈÔ˘˜
·ÛıÂÓ›˜. ∆Ô Â¿Ó ·˘Ùfi ÙÔ Â‡ÚËÌ· ¤¯ÂÈ Î¿ÔÈ· ·ıÔÊ˘ÛÈÔÏÔÁÈ΋ Û˘Û¯¤ÙÈÛË Ì ÙÔ Û‡Ó‰ÚÔÌÔ ·Ú·Ì¤ÓÂÈ ·ÎfiÌË ¿ÁÓˆÛÙÔ.
¶›Ó·Î·˜ 1. ∫ÚÈÙ‹ÚÈ· ÁÈ· ÙË ‰È¿ÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ∆ako
Tsubo Ô˘ ¤¯Ô˘Ó ÚÔÙ·ı› ·fi ÙËÓ Mayo Clinic.42
1. ¶·ÚÔ‰È΋ ·ÎÈÓËÛ›· ‹ ‰˘ÛÎÈÓËÛ›· Ù˘ ÎÔÚ˘Ê‹˜ Ù˘ ·ÚÈÛÙÂÚ‹˜
ÎÔÈÏ›·˜ Î·È ÙˆÓ Ì¤ÛˆÓ ÙÌËÌ¿ÙˆÓ Ì ÙÌËÌ·ÙÈΤ˜ ‰È·Ù·Ú·¯¤˜ Ù˘
ÎÈÓËÙÈÎfiÙËÙ·˜ Ô˘ ÂÎÙ›ÓÔÓÙ·È ¤Ú·Ó Ù˘ ηٷÓÔÌ‹˜ ÂÓfi˜
ÂÈηډȷÎÔ‡ ÛÙÂÊ·ÓÈ·›Ô˘ ·ÁÁ›Ԣ.
2. ∞Ô˘Û›· ·fiÊڷ͢ ÛÙÂÊ·ÓÈ·›Ô˘ ·ÁÁ›Ԣ ‹ ·ÁÁÂÈÔÁÚ·ÊÈ΋˜
¤Ó‰ÂÈ͢ ڋ͢ ·ıËڈ̷ÙÈ΋˜ Ͽη˜.
3. ¡ÂÔÂÌÊ·ÓÈÛı›Û˜ ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈΤ˜ ·ÓˆÌ·Ï›Â˜ (·Ó¿Û·ÛË ÙÔ˘ ST ‹ ·Ó·ÛÙÚÔÊ‹ ÙˆÓ Î˘Ì¿ÙˆÓ T)
4. ∞Ô˘Û›· ÂÓfi˜ ·fi Ù· ·Ú·Î¿Ùˆ:
¶ÚfiÛÊ·ÙÔ ÙÚ·‡Ì· ÎÂÊ·Ï‹˜
∂Ó‰ÔÎÚ¿ÓÈ· ·ÈÌÔÚÚ·Á›·
º·ÈÔ¯ÚˆÌÔ·Ùو̷
∞fiÊÚ·ÍË ÂÈηډȷÎÒÓ ÛÙÂÊ·ÓÈ·›ˆÓ ·ÁÁ›ˆÓ
ª˘Ôηډ›Ùȉ·
ÀÂÚÙÚÔÊÈ΋ Ì˘ÔηډÈÔ¿ıÂÈ·
.
ªÂ ‚¿ÛË ÙËÓ ÂÌÂÈÚ›· Ù˘ Î·È ÙȘ ˘¿Ú¯Ô˘Û˜
ÁÓÒÛÂȘ, ÌÈ· ÔÌ¿‰· ·fi ÙËÓ Mayo Clinic ¤¯ÂÈ ÚÔÙ›ÓÂÈ Î¿ÔÈ· ÎÚÈÙ‹ÚÈ· ÁÈ· ÙËÓ ÎÏÈÓÈ΋ ‰È¿ÁÓˆÛË ÙÔ˘
TTC (¶›Ó·Î·˜ 1) 42 ·Ó·ÁÓˆÚ›˙ÔÓÙ·˜ Ê˘ÛÈο ˆ˜
˘¿Ú¯Ô˘Ó Î·È ÔÈ ÂÍ·ÈÚ¤ÛÂȘ.
∞ÓÙÈÌÂÙÒÈÛË Î·È ¶ÚfiÁÓˆÛË
∏ ȉ·ÓÈ΋ ıÂÚ·›· ÁÈ· ÙÔ TTC ·Ú·Ì¤ÓÂÈ ¿ÁÓˆÛÙË. ∏ ·Ú¯È΋ ·ÓÙÈÌÂÙÒÈÛË Ú¤ÂÈ Ó· Û˘Ó›ÛٷٷÈ
ÛÙËÓ ·ÓÙÈÌÂÙÒÈÛË Ù˘ Ì˘Ôηډȷ΋˜ ÈÛ¯·ÈÌ›·˜.43 √
·ÛıÂÓ‹˜ ı· Ú¤ÂÈ Ó· ˘Ô‚¿ÏÏÂÙ·È ¿ÌÂÛ· Û ÛÙÂÊ·ÓÈÔÁÚ·Ê›· ηıÒ˜ Ë ‰È¿ÁÓˆÛË ÙÔ˘ TTC fiˆ˜ ›‰·Ì ··ÈÙ› ÙÔÓ ·ÔÎÏÂÈÛÌfi Ù˘ ‡·Ú͢ ÛËÌ·ÓÙÈ΋˜ ÛÙ¤ÓˆÛ˘ ÙˆÓ ÛÙÂÊ·ÓÈ·›ˆÓ ·ÁÁ›ˆÓ. ∂ÈÚfiÛıÂÙ·, Ô Î¿ı ·ÛıÂÓ‹˜ Ô˘ ÂÌÊ·Ó›˙ÂÈ Ô͇ ÛÙËı·Á¯ÈÎfi ¿ÏÁÔ˜, ËÏÂÎÙÚÔηډÈÔÁÚ·ÊÈΤ˜ ‰È·Ù·Ú·¯¤˜ ηÈ
‰È·Ù·Ú·¯¤˜ ÎÈÓËÙÈÎfiÙËÙ·˜ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ Â›Ó·È Ôχ ÈÔ Èı·Ófi Ó· ¿Û¯ÂÈ ·fi √∂ª, ÔfiÙ ٷ
ÔʤÏË ·fi ÙËÓ ÚˆÙÔÁÂÓ‹ ·ÁÁÂÈÔÏ·ÛÙÈ΋ Â›Ó·È Ôχ ÛËÌ·ÓÙÈο. °È· ÙÔÓ ›‰ÈÔ ÏfiÁÔ, ı· Ú¤ÂÈ ·Ì¤Ûˆ˜
Ó· ·Ú¯›˙ÂÈ ıÂÚ·›· Ì ¯ÔÚ‹ÁËÛË ·ÛÈÚ›Ó˘, ÎÏÔȉÔÁÚ¤Ï˘, ÓÈÙÚˆ‰ÒÓ, ÂÓ‰ÔÊϤ‚È·˜ Ë·Ú›Ó˘ Î·È ‚ –
·Ó·ÛÙÔϤˆÓ. ∂›Û˘, ÂӉ›ÎÓ˘Ù·È Ë Û˘Ó¯‹˜ ·ÈÌÔ‰˘Ó·ÌÈ΋ ·Ú·ÎÔÏÔ‡ıËÛË ÙÔ˘ ·ÛıÂÓÔ‡˜ ÁÈ· ÙËÓ Èı·Ó‹ ÂÌÊ¿ÓÈÛË Î·Ú‰È·Î‹˜ ·ÓÂ¿ÚÎÂÈ·˜, ηډÈÔÁÂÓÔ‡˜
ηٷÏËÍ›·˜ ‹ ηÎÔ‹ıˆÓ ·ÚÚ˘ıÌÈÒÓ. ∂ÊfiÛÔÓ ‚¤‚·È· ÙÂı› Ë ‰È¿ÁÓˆÛË ÙÔ˘ TTC, ÙfiÛÔ Ù· ·ÓÙÈ·ÈÌÔÂÙ·Ïȷο fiÛÔ Ù· ÓÈÙÚÒ‰Ë Ú¤ÂÈ Ó· ‰È·ÎÔÔ‡Ó.
∞fi ÙËÓ ¿ÏÏË, ÔÈ ‚ – ·Ó·ÛÙÔÏ›˜ Ú¤ÂÈ Ó· Û˘Ó¯›ÛÔ˘Ó Ó· ¯ÔÚËÁÔ‡ÓÙ·È, ÌÈ·˜ Î·È ÔÈ Î·Ù¯ÔϷ̛Ә
ÂÓÔ¯ÔÔÈÔ‡ÓÙ·È ÁÈ· ÙÔ ÎÏÈÓÈÎfi ·˘Ùfi Û‡Ó‰ÚÔÌÔ, ÂÓÒ
·Ú¿ÏÏËÏ· ··ÈÙÂ›Ù·È ¤Ó·ÚÍË ·Ó·ÛÙÔϤˆÓ ÙÔ˘ ÌÂÙ·ÙÚÂÙÈÎÔ‡ ÂÓ˙‡ÌÔ˘ ̤¯ÚȘ fiÙÔ˘ ‚ÂÏÙȈı› Ë Î·Ú‰È·Î‹ ÏÂÈÙÔ˘ÚÁ›·. ∆· ‰ÈÔ˘ÚËÙÈο ıˆÚÔ‡ÓÙ·È ··Ú·›ÙËÙ· ÂÊfiÛÔÓ ˘¿Ú¯Ô˘Ó Û˘ÌÙÒÌ·Ù· Û˘ÌÊÔÚËÙÈ΋˜ ηډȷ΋˜ ·ÓÂ¿ÚÎÂÈ·˜. ™ÙËÓ ÂÚ›ÙˆÛË ÛÔ‚·ÚÔ‡ ‚·ıÌÔ‡ Û˘ÛÙÔÏÈ΋˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›·˜ ··ÈÙ›ٷÈ
ıÂÚ·›· Ì ·ÓÙÈËÎÙÈο, ÒÛÙ ӷ ÂÏ·ÙÙˆı› Ô Î›Ó‰˘ÓÔ˜ ıÚÔÌ‚ÔÂÌ‚ÔÏÈÎÒÓ ÂÂÈÛÔ‰›ˆÓ.44 ∂› ÛÔ‚·Ú‹˜
˘fiÙ·Û˘ ı· ÌÔÚÔ‡Û·Ó Ó· ‰ÔÎÈÌ·ÛÙÔ‡Ó ÔÈ ‚ – ·Ó·ÛÙÔÏ›˜ Â¿Ó Ë ˘fiÙ·ÛË ÔÊ›ÏÂÙ·È Û ·fiÊÚ·ÍË ÙÔ˘
¯ÒÚÔ˘ ÂÍfi‰Ô˘ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ ÏfiÁˆ ÌÂÙ·‚ÔÏ‹˜ Ù˘ ÁˆÌÂÙÚ›·˜ Ù˘ ηٿ ÙË Û˘ÛÙÔÏ‹. øÛÙfiÛÔ,
Â¿Ó ˘¿Ú¯ÂÈ ·ÓÂ¿ÚÎÂÈ· ·ÓÙÏ›·˜ ÂӉ›ÎÓ˘Ù·È Ë ¯ÔÚ‹ÁËÛË ÈÓÔÙÚfiˆÓ ‹ Ë ÂÊ·ÚÌÔÁ‹ ÂÓ‰Ô·ÔÚÙÈ΋˜
·ÓÙÏ›·˜. ∫¿ÔÈÔÈ Û˘ÁÁÚ·Ê›˜ Û˘ÓËÁÔÚÔ‡Ó ˘¤Ú Ù˘
¿ÌÂÛ˘ ÙÔÔı¤ÙËÛ˘ ÂÓ‰Ô·ÔÚÙÈ΋˜ ·ÓÙÏ›·˜ ηıÒ˜ Ë
¯Ú‹ÛË ÈÓÔÙÚfiˆÓ ÌÔÚ› Ó· ÂȉÂÈÓÒÛÂÈ ÙËÓ ‹‰Ë ·˘ÍË̤ÓË ÂÓ‰ÔÎÔÈÏÔÙÈ΋ ÎÏ›ÛË ›ÂÛ˘. ∂ÈÚfiÛıÂÙ·,
ÂÊfiÛÔÓ ÔÈ Î·Ù¯ÔϷ̛Ә Î·È Ë ÚÔηÏÔ‡ÌÂÓË ·fi
..
·˘Ù¤˜ ÙÔÍÈÎfiÙËÙ· ıˆÚÔ‡ÓÙ·È ˘‡ı˘Ó˜ ÁÈ· ÙËÓ ÂÌÊ¿ÓÈÛË TTC, Ë ‰Ô‚Ô˘Ù·Ì›ÓË Î·È Ë ÓÙÔ·Ì›ÓË ı·
ÌÔÚÔ‡Û·Ó ıˆÚËÙÈο Ó· ÂȉÂÈÓÒÛÔ˘Ó ÙË ‰˘ÛÏÂÈÙÔ˘ÚÁ›· Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜. ∞fi ÙËÓ ¿ÏÏË, Ë Ï‚ÔÛÈÌÂÓ‰¿ÓË Ô˘ Â›Ó·È Â˘·ÈÛıËÙÔÔÈËÙ‹˜ ·Û‚ÂÛÙ›Ô˘, ı· ÌÔÚÔ‡Û ӷ ·ÔÙÂÏ› ÌÈ· ‰Â‡ÙÂÚ˘ ÁÚ·ÌÌ‹˜
ıÂÚ·›·. 28 ™ÙËÓ ÂÚ›ÙˆÛË ÂÌÊ¿ÓÈÛ˘ ÛÔ‚·ÚÔ‡
‚·ıÌÔ‡ ηډÈÔÁÂÓÔ‡˜ ηٷÏËÍ›·˜ Ë ÚÔÛˆÚÈÓ‹
Ì˯·ÓÈ΋ ˘Ô‚Ô‹ıËÛË Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ ÌÔÚ›
Ó· ηٷÛÙ› ·Ó·Áη›·. ∂‰Ò, ı· Ú¤ÂÈ Ó· ÙÔÓÈÛÙ›
ˆ˜ η̛· ·fi ÙȘ ·Ú·¿Óˆ ıÂÚ·¢ÙÈΤ˜ ÂÈÏÔÁ¤˜ ‰ÂÓ ¤¯ÂÈ ‰ÔÎÈÌ·ÛÙ› ÛÙËÓ ÎÏÈÓÈ΋ Ú¿ÍË, οÙÈ
Ô˘ ‰ÂÓ ÌÔÈ¿˙ÂÈ Èı·ÓfiÓ Ó· Û˘Ì‚Â› Î·È ÛÙÔ ¿ÌÂÛÔ
̤ÏÏÔÓ ‰Â‰Ô̤ÓÔ˘ ÙÔ˘ ¯·ÌËÏÔ‡ ÂÈÔÏ·ÛÌÔ‡ ÙÔ˘
Û˘Ó‰ÚfiÌÔ˘ Î·È Ù˘ ηÏÔ‹ıÔ˘˜ ÚfiÁÓˆÛ‹˜ ÙÔ˘.
∏ ‰È¿ÚÎÂÈ· Ù˘ ıÂÚ·›·˜ ‰ÂÓ ¤¯ÂÈ Â›Û˘ ·ÔÛ·ÊËÓÈÛÙ› ·ÏÏ¿ ÌÔÈ¿˙ÂÈ ÏÔÁÈÎfi Ó· ·Ú·Ù›ÓÂÙ·È
¤ˆ˜ fiÙÔ˘ Ê˘ÛÈÔÏÔÁÈÎÔÔÈËı› Ï‹Úˆ˜ Ë Î·Ú‰È·Î‹
ÏÂÈÙÔ˘ÚÁ›·.
∏ ÚfiÁÓˆÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ Û˘Ó‹ıˆ˜ Â›Ó·È Î·Ï‹ Ì Ï‹ÚË ·ÔηٿÛÙ·ÛË Ù˘ ÏÂÈÙÔ˘ÚÁÈÎfiÙËÙ·˜
Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ ÂÓÙfi˜ 2 – 4 ‚‰ÔÌ¿‰ˆÓ ·fi
ÙËÓ ¤Ó·ÚÍË ÙˆÓ Û˘ÌÙˆÌ¿ÙˆÓ ÛÙËÓ ÏÂÈÔÓfiÙËÙ· ÙˆÓ
ÂÚÈÙÒÛˆÓ. √È ÈÔ Û˘¯Ó¤˜ ÂÈÏÔΤ˜ Ô˘ ¤¯Ô˘Ó
ÂÚÈÁÚ·Ê›, ·Ó¿ÏÔÁ· Ì ÙÔ ÔÛÔÛÙfi ÂÌÊ¿ÓÈÛ˘, Â›Ó·È ÔÈ ·ÎfiÏÔ˘ı˜: ηډÈÔÁÂÓ‹˜ ηٷÏËÍ›· (6,5%),
Û˘ÌÊÔÚËÙÈ΋ ηډȷ΋ ·ÓÂ¿ÚÎÂÈ· (3,8%), ÎÔÈÏȷ΋ Ù·¯˘Î·Ú‰›· (1,6%) Î·È ı¿Ó·ÙÔ˜ (3,2%).16 ªÔÏ·Ù·‡Ù· ¤¯Ô˘Ó ÂÚÈÁÚ·Ê› Î·È ˘„ËÏfiÙÂÚ· ÔÛÔÛÙ¿
ıÓËÛÈÌfiÙËÙ·˜ ¿Óˆ ÙÔ˘ 21%.33 ÕÏϘ Û·ÓÈfiÙÂÚ˜
ÛÔ‚·Ú¤˜ ÂÈÏÔΤ˜ Â›Ó·È Ë Ú‹ÍË ÙÔ˘ ÌÂÛÔÎÔÈÏÈ·ÎÔ‡
‰È·ÊÚ¿ÁÌ·ÙÔ˜, Ë Ú‹ÍË ÙÔ˘ ÂÏ¢ı¤ÚÔ˘ ÙÔȯÒÌ·ÙÔ˜
Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜, Ô Û¯ËÌ·ÙÈÛÌfi˜ ıÚfiÌ‚Ô˘ ÛÙËÓ
ÎÔÚ˘Ê‹ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜ Î·È Ë ÂÌÊ¿ÓÈÛË ·ÁÁÂÈ·ÎÔ‡ ÂÁÎÂÊ·ÏÈÎÔ‡ ÂÂÈÛÔ‰›Ô˘.45,31 ¶·Ú¿ÁÔÓÙ˜
fiˆ˜ Ë ËÏÈΛ·, ÙÔ stress Î·È Ë ·Ó·ÛÙÚÔÊ‹ ÙˆÓ Î˘Ì¿ÙˆÓ ∆ ¤¯Ô˘Ó Û˘Û¯ÂÙÈÛı› Ì ·˘ÍË̤ÓÔ Î›Ó‰˘ÓÔ ÂÌÊ¿ÓÈÛ˘ ÂÈÏÔÎÒÓ.35 ∆¤ÏÔ˜, ·Ó Î·È Û¿ÓÈ·, ¤¯Ô˘Ó
·Ó·ÊÂÚı› ˘ÔÙÚÔ¤˜ ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘.36,37
™˘ÌÂÚ¿ÛÌ·Ù·
∆Ô Û‡Ó‰ÚÔÌÔ Tako – Tsubo ‹ Ì˘ÔηډÈÔ¿ıÂÈ· ·fi
stress ·ÔÙÂÏ› ÌÈ· ÌÔÚÊ‹ Ì˘ÔηډÈÔ¿ıÂÈ·˜ Ô˘
·Ó·ÁÓˆÚ›˙ÂÙ·È Û˘Ó¯Ҙ Û ·˘Í·ÓfiÌÂÓÔ ÔÛÔÛÙfi ˆ˜
ÚˆÙÔ·ı‹˜ ÌÔÚÊ‹ Ì˘ÔηډÈÔ¿ıÂÈ· Ô˘ Û˘Ì‚·›ÓÂÈ ÌÂÙ¿ ·fi οÔÈÔ ÛÙÚÂÛÛÔÁfiÓÔ ÂÂÈÛfi‰ÈÔ Î·È ¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi ·ÚÔ‰È΋ Û˘ÛÙÔÏÈ΋ ‰˘ÛÏÂÈÙÔ˘ÚÁ›· ΢ڛˆ˜ ÛÙËÓ ÎÔÚ˘Ê‹ Ù˘ ·ÚÈÛÙÂÚ‹˜ ÎÔÈÏ›·˜. ∏
ÎÏÈÓÈ΋ ÂÌÊ¿ÓÈÛË ÙÔ˘ Û˘Ó‰ÚfiÌÔ˘ ÚÔÛÔÌÔÈ¿˙ÂÈ ÌÂ
·˘Ù‹ ÙÔ˘ ÔͤԘ ÛÙÂÊ·ÓÈ·›Ô˘ Û˘Ó‰ÚfiÌÔ˘ Ì ÛÙËı·Á-.
¯ÈÎfi ¿ÏÁÔ˜, ÈÛ¯·ÈÌÈÎÔ‡ Ù‡Ô˘ ·ÏÏÔÈÒÛÂȘ ÙÔ˘ ST ηÈ
ÌÈÎÚ‹ ·‡ÍËÛË ÙˆÓ Ì˘ÔηډȷÎÒÓ ÂÓ˙‡ÌˆÓ. ∏ ÚfiÁÓˆÛË Â›Ó·È Î·Ï‹ Ì Ï‹ÚË ·ÔηٿÛÙ·ÛË Ù˘ ηډȷ΋˜ ÏÂÈÙÔ˘ÚÁ›·˜ ÂÓÙfi˜ 2 – 4 ‚‰ÔÌ¿‰ˆÓ ÛÙËÓ
ÏÂÈÔÓfiÙËÙ· ÙˆÓ ÂÚÈÙÒÛˆÓ. ∏ ‰ÈÂÓ¤ÚÁÂÈ· ÛÙÂÊ·ÓÈÔÁÚ·Ê›·˜ Â›Ó·È ··Ú·›ÙËÙË ÁÈ· Ó· ÙÂı› Ë ‰È¿ÁÓˆÛË ÂÓÒ Ë Ê·Ú̷΢ÙÈ΋ ıÂÚ·›· ‰Ú· ˘ÔÛÙËÚÈÎÙÈο. √ ·ıÔÁÂÓÂÙÈÎfi˜ Ì˯·ÓÈÛÌfi˜ ·Ú·Ì¤ÓÂÈ ÚÔ˜
ÙÔ ·ÚfiÓ ¿ÁÓˆÛÙÔ˜ ·Ó Î·È Ë ·˘ÍË̤ÓË Û˘ÁΤÓÙÚˆÛË
ηÙ¯ÔÏ·ÌÈÓÒÓ Ê·›ÓÂÙ·È Û·ÊÒ˜ Ó· ‰È·‰Ú·Ì·Ù›˙ÂÈ
ÚˆÙ‡ÔÓÙ· ÚfiÏÔ.
BÈ‚ÏÈÔÁÚ·Ê›·
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