Dina Bento1, Olga Azevedo2, Rui Santos3, Ana Almeida4, Kevin Domingues5, Bruno Marmelo6, Liliana Reis7, Catarina Ruivo8, Rui Guerreiro9, Rui Lima10, Ricardo Faria2, Ana Marreiros11, Nuno Marques12. 1. Cardiology Department, Centro Hospitalar Universitário do Algarve Faro, Portugal; Algarve Biomedical Center, Faro, Portugal. Electronic address: dinabento@gmail.com. 2. Cardiology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal. 3. Cardiology Department, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. 4. Cardiology Department, Hospital Garcia de Orta, Almada, Portugal. 5. Cardiology Department, Hospital de Santarém, Santarém, Portugal. 6. Cardiology Department, Centro Hospitalar Tondela-Viseu, Portugal. 7. Cardiology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 8. Cardiology Department, Centro Hospitalar de Leiria, Leiria, Portugal. 9. Cardiology Department, Hospital do Espírito Santo, Évora, Portugal. 10. Cardiology Department, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal. 11. Algarve Biomedical Center, Faro, Portugal; Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Faro, Portugal. 12. Cardiology Department, Centro Hospitalar Universitário do Algarve Faro, Portugal; Algarve Biomedical Center, Faro, Portugal; Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Faro, Portugal.
Abstract
INTRODUCTION: Takotsubo syndrome (TTS) is characterized by transient left ventricular (LV) systolic dysfunction. AIM: To characterize a Portuguese population with TTS and to determine their short- and medium-term prognosis. METHODS: We conducted a multicenter study in Portuguese hospitals that included all patients diagnosed with TTS, initially retrospectively and subsequently prospectively. Short- and medium-term clinical complications and mortality were assessed. Independent predictors of in-hospital complications and prognostic factors were determined. RESULTS: A total of 234 patients (210 female, age 68±12 years) were included. During hospitalization, 32.9% of patients had complications: acute heart failure (24.4%), atrial fibrillation (9.0%), ventricular arrhythmias (2.6%), complete atrioventricular block (2.1%), stroke/transient ischemic attack (1.7%), and LV thrombus (1.3%). Chronic kidney disease (CKD) (p=0.02), coronary artery disease (CAD) (p=0.027), lower LV ejection fraction (LVEF) on admission (p=0.003), and dyspnea at presentation (p=0.019) were predictors of in-hospital complications. In-hospital mortality was 2.2%. At the mean follow-up of 33±33 months, all-cause mortality was 4.4%, cardiovascular mortality was 0.9% and TTS recurrence was 4.4%. Prolonged QTc interval on admission was associated with complications in follow-up (p=0.001). CONCLUSION: TTS has a good short- and medium-term prognosis. However, the rate of in-hospital complications is high and should not be overlooked. Dyspnea at presentation, CKD, CAD and lower LVEF on admission were independent predictors of in-hospital complications. Prolonged QTc on admission was associated with complications in follow-up.
INTRODUCTION:Takotsubo syndrome (TTS) is characterized by transient left ventricular (LV) systolic dysfunction. AIM: To characterize a Portuguese population with TTS and to determine their short- and medium-term prognosis. METHODS: We conducted a multicenter study in Portuguese hospitals that included all patients diagnosed with TTS, initially retrospectively and subsequently prospectively. Short- and medium-term clinical complications and mortality were assessed. Independent predictors of in-hospital complications and prognostic factors were determined. RESULTS: A total of 234 patients (210 female, age 68±12 years) were included. During hospitalization, 32.9% of patients had complications: acute heart failure (24.4%), atrial fibrillation (9.0%), ventricular arrhythmias (2.6%), complete atrioventricular block (2.1%), stroke/transient ischemic attack (1.7%), and LV thrombus (1.3%). Chronic kidney disease (CKD) (p=0.02), coronary artery disease (CAD) (p=0.027), lower LV ejection fraction (LVEF) on admission (p=0.003), and dyspnea at presentation (p=0.019) were predictors of in-hospital complications. In-hospital mortality was 2.2%. At the mean follow-up of 33±33 months, all-cause mortality was 4.4%, cardiovascular mortality was 0.9% and TTS recurrence was 4.4%. Prolonged QTc interval on admission was associated with complications in follow-up (p=0.001). CONCLUSION: TTS has a good short- and medium-term prognosis. However, the rate of in-hospital complications is high and should not be overlooked. Dyspnea at presentation, CKD, CAD and lower LVEF on admission were independent predictors of in-hospital complications. Prolonged QTc on admission was associated with complications in follow-up.
Authors: Anastasiia V Bairashevskaia; Sofiya Y Belogubova; Mikhail R Kondratiuk; Daria S Rudnova; Susanna S Sologova; Olga I Tereshkina; Esma I Avakyan Journal: Int J Cardiol Heart Vasc Date: 2022-03-07
Authors: David Zweiker; Edita Pogran; Laura Gargiulo; Ahmed Abd El-Razek; Ivan Lechner; Ivan Vosko; Stefan Rechberger; Heiko Bugger; Günter Christ; Diana Bonderman; Evelyn Kunschitz; Clara Czedik-Eysenberg; Antonia Roithinger; Valerie Weihs; Christoph C Kaufmann; Andreas Zirlik; Axel Bauer; Bernhard Metzler; Thomas Lambert; Clemens Steinwender; Kurt Huber Journal: Biology (Basel) Date: 2022-08-01