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Heart, Lung and Circulation
Original Article| Volume 19, ISSUE 10, P601-605, October 2010

Long-term Outcome of Tako-tsubo Cardiomyopathy

      Background

      Current data suggest an excellent outcome for patients with Tako-tsubo cardiomyopathy (TC). The objectives of this study were to evaluate the long-term outcome and the prognostic implication of thrombolysis in myocardial infarction myocardial perfusion grade (TMPG) in patients with TC.

      Methods

      Retrospective analysis of all patients diagnosed with TC at our hospital between 2003 and 2008.

      Results

      During the five-year period, we identified 27 patients with TC out of 1374 cases of emergent left heart catheterisation (2%). Mean follow-up was 27 ± 16 months. The majority were Caucasian (81%) female (96%), postmenopausal (96%), with a mean age of 68 ± 14 years. A precipitating stressor event was found in 74% of the patients, 30% being gastrointestinal triggers. Fourteen patients (52%) reached a combined end point of all cause death, cardiogenic shock, sudden cardiac death and rehospitalisation for cardiac reasons. TMPG was abnormal in 37% cases with no correlation with the outcome.

      Conclusions

      The long-term outcome of patients with TC is worse than previously reported. TMPG does not correlate with the outcome in TC.

      Keywords

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      References

        • Dote K.
        • Satoh H.
        • Tateishi H.
        • Uchida T.
        • Ishihara M.
        Myocardial stunning due to simultaneous multivessel spasm: a review of five cases.
        J Cardiol. 1991; 21: 201-214
        • Wittstein I.S.
        • Thiemann D.R.
        • Lima J.A.
        • Baughman K.L.
        • Schulman S.P.
        • Gerstenblith G.
        • Wu K.C.
        • Rade J.J.
        • Bivalacqua T.J.
        • Champion H.C.
        Neurohumoral features of myocardial stunning due to sudden emotional stress.
        N Engl J Med. 2005; 352: 539-548
        • Ibanez B.
        • Benezet-Mazuecos J.
        • Navarro F.
        • Farre J.
        Takotsubo syndrome: a Bayesian approach to interpreting its pathogenesis.
        Mayo Clin Proc. 2006; 81: 732-735
        • Chao T.
        • Lindsay J.
        • Collins S.
        • Woldeyes L.
        • Joshi S.B.
        • Steinberg D.H.
        • Satler L.F.
        • Kent K.M.
        • Suddath W.O.
        • Pichard A.D.
        • Waksman R.
        Can acute occlusion of the left anterior descending coronary artery produce a typical “takotsubo” left ventricular contraction pattern?.
        Am J Cardiol. 2009; 104: 202-204
        • Kurisu S.
        • Sato H.
        • Kawagoe T.
        • Ishihara M.
        • Shimatani Y.
        • Nishioka K.
        • Kono Y.
        • Umemura T.
        • Nakamura S.
        Tako-tsubo-like left ventricular dysfunction with ST-segment elevation: a novel cardiac syndrome mimicking acute myocardial infarction.
        Am Heart J. 2002; 143: 448-455
        • Pilgrim T.M.
        • Wyss T.R.
        Takotsubo cardiomyopathy or transient left ventricular apical ballooning syndrome: a systematic review.
        Int J Cardiol. 2008; 124: 283-292
        • Gibson C.M.
        • Cannon C.P.
        • Murphy S.A.
        • Ryan K.A.
        • Mesley R.
        • Marble S.J.
        • McCabe C.H.
        • Van De Werf F.
        • Braunwald E.
        Relationship of TIMI myocardial perfusion grade to mortality after administration of thrombolytic drugs.
        Circulation. 2000; 101: 125-130
        • Prasad A.
        • Lerman A.
        • Rihal C.S.
        Apical ballooning syndrome (tako-tsubo or stress cardiomyopathy): a mimic of acute myocardial infarction.
        Am Heart J. 2008; 155: 408-417
        • Sharkey S.W.
        • Windenburg D.C.
        • Lesser J.R.
        • Maron M.S.
        • Hauser R.G.
        • Lesser J.N.
        • Haas T.S.
        • Hodges J.S.
        • Maron B.J.
        Natural history and expansive clinical profile of stress (tako-tsubo) cardiomyopathy.
        J Am Coll Cardiol. 2010; 55: 333-341
        • Brilakis E.S.
        • Hernandez A.F.
        • Dai D.
        • Peterson E.D.
        • Banerjee S.
        • Fonarow G.C.
        • Cannon C.P.
        • Bhatt D.L.
        Quality of care for acute coronary syndrome patients with known atherosclerotic disease. Results from the Get With the Guidelines Program.
        Circulation. 2009; 120: 560-567
        • Elesber A.
        • Lerman A.
        • Bybee K.A.
        • Murphy J.G.
        • Barsness G.
        • Singh M.
        • Rihal C.S.
        • Prasad A.
        Myocardial perfusion in apical ballooning syndrome: correlate of myocardial injury.
        Am Heart J. 2006; 152: e9-e13
        • Doba N.
        • Reis D.J.
        Role of central and peripheral adregergic mechanisms in neurogenic hypertension produced by brainstem lesions in rat.
        Circ Res. 1974; 34: 293-301
        • Downing S.E.
        • Lee J.C.
        Contribution of alpha-adrenoreceptor activation to the pathogenesis of norepinephrine cardiomyopathy.
        Circ Res. 1983; 52: 471-478