Assessment of intra and extra-hospital outcome after Takotsubo Syndrome in a single-center population

Authors

Roberto Licordari, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.
Roberta Manganaro, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.
Maurizio Cusmà-Piccione, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.Follow
Giuseppe Dattilo, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.Follow
Rodolfo Citro, Department of Cardiology, University Hospital "San Giovanni di Dio e Ruggi d' Aragona", Salerno, Italy.Follow
Bijoy K. Khandheria, Advocate Aurora HealthFollow
Gianluca Di Bella, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.
Concetta Zito, Department of Clinical and Experimental Medicine, University of Messina, Azienda Ospedaliera Universitaria "Policlinico G. Martino", Salerno, Italy.

Recommended Citation

Licordari R, Manganaro R, Cusmà-Piccione M, et al. Assessment of Intra and Extra-Hospital Outcome after Takotsubo Syndrome in a Single-Center Population. J Cardiovasc Echogr. 2021;31(4):207-213. doi:10.4103/jcecho.jcecho_47_21

Affiliations

Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers

Abstract

Objectives: To evaluate short- and long-term outcome in a single prospective cohort of Takotsubo syndrome (TTS) patients, trying to early identify those with better prognosis and to assess the prevalence of left ventricular ejection fraction (LVEF) recovery over time. Methods: Forty-nine patients prospectively enrolled underwent to assessment of demographic, clinical, and echocardiographic characteristics, and later were followed to identify the outcomes during a mean follow-up (FU) of 93 months. At the end of the FU phase, a subgroup of patients underwent to a clinical and echocardiographic re-evaluation. As major adverse cardiac events (MACE) were considered: Intra and extra-hospital death, re-hospitalizations for acute heart failure or atrial fibrillation (AF) or acute myocardial infarction (AMI) and TTS recurrence; minor events were considered minor symptoms of heart failure and angina not requiring hospitalization. Results: The prevalence of re-hospitalizations (MACE) over time was: 41% ( = 12) for HF; 6.8% ( = 2) for AMI; 3.4% ( = 1) for TTS relapse and 20% ( = 6) for AF. Minor events were the symptoms of chest pain and dyspnea not requiring hospitalization in 6 (20.7%) and 12 (34.4%) patients, respectively. LVEF at the time of admission was predictor for MACE. Stratifying patients on the LVEF admission median value (40%). Patients with LVEF <40% at admission had a significantly lower survival free from adverse cardiac events compared to patients with LVEF ≥40%. Twenty-seven (93%) patients underwent to a clinical reassessment with electrocardiogram and echocardiographic examination. LVEF value showed a statistically significant increase ( = 0.004) at the end of FU. Conclusions: At admission, "high-risk" patients (LVEF <40%) can be easily detected, allowing an appropriate pharmacological and/or mechanical support strategy and a more "careful" FU.

Type

Article

PubMed ID

35284215