TY - JOUR
T1 - Clinical Predictors and Prognostic Impact of Recovery of Wall Motion Abnormalities in Takotsubo Syndrome
T2 - Results From the International Takotsubo Registry
AU - International Takotsubo registry
AU - Jurisic, Stjepan
AU - Gili, Sebastiano
AU - Cammann, Victoria L.
AU - Kato, Ken
AU - Szawan, Konrad A.
AU - D'Ascenzo, Fabrizio
AU - Jaguszewski, Milosz
AU - Bossone, Eduardo
AU - Citro, Rodolfo
AU - Sarcon, Annahita
AU - Napp, L. Christian
AU - Franke, Jennifer
AU - Noutsias, Michel
AU - Knorr, Maike
AU - Heiner, Susanne
AU - Burgdorf, Christof
AU - Koenig, Wolfgang
AU - Pott, Alexander
AU - Kherad, Behrouz
AU - Rajan, Lawrence
AU - Michels, Guido
AU - Pfister, Roman
AU - Cuneo, Alessandro
AU - Jacobshagen, Claudius
AU - Karakas, Mahir
AU - Meyer, Philippe
AU - Arroja, Jose David
AU - Banning, Adrian
AU - Cuculi, Florim
AU - Kobza, Richard
AU - Fischer, Thomas A.
AU - Vasankari, Tuija
AU - Airaksinen, K. E.Juhani
AU - Dworakowski, Rafal
AU - Kaiser, Christoph
AU - Osswald, Stefan
AU - Galiuto, Leonarda
AU - Dichtl, Wolfgang
AU - Chan, Christina
AU - Bridgman, Paul
AU - Beug, Daniel
AU - Delmas, Clément
AU - Lairez, Olivier
AU - Kozel, Martin
AU - Tousek, Petr
AU - Winchester, David E.
AU - Gilyarova, Ekaterina
AU - Shilova, Alexandra
AU - Gilyarov, Mikhail
AU - Crea, Filippo
PY - 2019/11/5
Y1 - 2019/11/5
N2 - Background: Left ventricular (LV) recovery in takotsubo syndrome (TTS) 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 TTS patients. Methods and Results: TTS patients from the International Takotsubo Registry were included in this study. Cut-off for early LV 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 LV recovery and 215 (53.0%) demonstrated late LV improvement. Patients without early recovery were more often male (12.6% versus 5.2%; P=0.011) and presented more frequently with typical TTS (76.3% versus 67.0%, P=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 (P=0.003). On multiple logistic regression, male sex, LV ejection fraction <45%, and acute neurologic disorders were associated with the absence of early recovery. Conclusions: TTS patients without early LV 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. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01947621.
AB - Background: Left ventricular (LV) recovery in takotsubo syndrome (TTS) 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 TTS patients. Methods and Results: TTS patients from the International Takotsubo Registry were included in this study. Cut-off for early LV 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 LV recovery and 215 (53.0%) demonstrated late LV improvement. Patients without early recovery were more often male (12.6% versus 5.2%; P=0.011) and presented more frequently with typical TTS (76.3% versus 67.0%, P=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 (P=0.003). On multiple logistic regression, male sex, LV ejection fraction <45%, and acute neurologic disorders were associated with the absence of early recovery. Conclusions: TTS patients without early LV 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. Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01947621.
KW - outcome
KW - recovery
KW - takotsubo syndrome
KW - wall motion abnormalities
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U2 - 10.1161/JAHA.118.011194
DO - 10.1161/JAHA.118.011194
M3 - Article
C2 - 31672100
AN - SCOPUS:85074428763
VL - 8
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 21
M1 - e011194
ER -