Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry

Media type: E-Article
Title: Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome: Results From the International Takotsubo Registry
Contributor: Jurisic, Stjepan; Gili, Sebastiano; Cammann, Victoria L.; Kato, Ken; Szawan, Konrad A.; D'Ascenzo, Fabrizio; Jaguszewski, Milosz; Bossone, Eduardo; Citro, Rodolfo; Sarcon, Annahita; Napp, L. Christian; Franke, Jennifer; Noutsias, Michel; Knorr, Maike; Heiner, Susanne; Burgdorf, Christof; Koenig, Wolfgang; Pott, Alexander; Kherad, Behrouz; Rajan, Lawrence; Michels, Guido; Pfister, Roman; Cuneo, Alessandro; Jacobshagen, Claudius; [...]
imprint: Ovid Technologies (Wolters Kluwer Health), 2019
Published in: Journal of the American Heart Association
Language: English
DOI: 10.1161/jaha.118.011194
ISSN: 2047-9980
Keywords: Cardiology and Cardiovascular Medicine
Origination:
Footnote:
Description: <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Left ventricular ( <jats:styled-content style="fixed-case">LV</jats:styled-content> ) recovery in takotsubo syndrome ( <jats:styled-content style="fixed-case">TTS</jats:styled-content> ) occurs over a wide‐ranging interval, varying from hours to weeks. We sought to investigate the clinical predictors and prognostic impact of recovery time for <jats:styled-content style="fixed-case">TTS</jats:styled-content> patients. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">TTS</jats:styled-content> patients from the International Takotsubo Registry were included in this study. Cut‐off for early <jats:styled-content style="fixed-case">LV</jats:styled-content> recovery was determined to be 10 days after the acute event. Multivariable logistic regression was used to assess factors associated with the absence of early recovery. In‐hospital outcomes and 1‐year mortality were compared for patients with versus without early recovery. We analyzed 406 patients with comprehensive and serial imaging data regarding time to recovery. Of these, 191 (47.0%) had early <jats:styled-content style="fixed-case">LV</jats:styled-content> recovery and 215 (53.0%) demonstrated late <jats:styled-content style="fixed-case">LV</jats:styled-content> improvement. Patients without early recovery were more often male (12.6% versus 5.2%; <jats:italic>P</jats:italic> =0.011) and presented more frequently with typical <jats:styled-content style="fixed-case">TTS</jats:styled-content> (76.3% versus 67.0%, <jats:italic>P</jats:italic> =0.040). Cardiac and inflammatory markers were higher in patients without early recovery than in those with early recovery. Patients without early recovery showed unfavorable 1‐year outcome compared with patients with early recovery ( <jats:italic>P</jats:italic> =0.003). On multiple logistic regression, male sex, LV ejection fraction <45%, and acute neurologic disorders were associated with the absence of early recovery. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> TTS patients without early <jats:styled-content style="fixed-case">LV</jats:styled-content> recovery have different clinical characteristics and less favorable 1‐year outcome compared with patients with early recovery. The factors associated with the absence of early recovery included male sex, reduced LV ejection fraction, and acute neurologic events. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 01947621. </jats:p> </jats:sec>
Access State: Open Access

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