Impact and management of left ventricular function on the prognosis of Takotsubo syndrome

• Verfasst von: El-Battrawy, Ibrahim [VerfasserIn]
• Verfasst von: Ansari, Uzair [VerfasserIn]
• Verfasst von: Lang, Siegfried [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Schramm, Katja [VerfasserIn]
• Verfasst von: Fastner, Christian [VerfasserIn]
• Verfasst von: Zhou, Xiao-Bo [VerfasserIn]
• Verfasst von: Kuschyk, Jürgen [VerfasserIn]
• Verfasst von: Tueluemen, Erol [VerfasserIn]
• Verfasst von: Röger, Susanne [VerfasserIn]
• Verfasst von: Borggrefe, Martin [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Titel: Impact and management of left ventricular function on the prognosis of Takotsubo syndrome
• Verf.angabe: Ibrahim El‐Battrawy, Uzair Ansari, Siegfried Lang, Michael Behnes, Katja Schramm, Christian Fastner, Xiaobo Zhou, Jürgen Kuschyk, Erol Tülümen, Susanne Röger, Martin Borggrefe and Ibrahim Akin
• Jahr: 2017
• Umfang: 9 S.
• Fussnoten: Gesehen am 24.05.2018
• Titel Quelle: Enthalten in: European journal of clinical investigation
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1970
• Jahr Quelle: 2017
• Band/Heft Quelle: 47(2017), 7, Seite 477-485
• ISSN Quelle: 1365-2362
• DOI: doi:10.1111/eci.12768
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Devices
• Sach-SW: echocardiography
• Sach-SW: ejection fraction
• Sach-SW: mortality
• Sach-SW: outcome
• Sach-SW: Takotsubo syndrome
• K10plus-PPN: 1575455870

Abstract

Background Early research has proposed that patients with Takotsubo syndrome (TTS) could have a higher mortality rate than the general population. Our study was conducted to determine the short- and long-term outcome of TTS patients associated with a significantly compromised left ventricular function on hospital admission. Materials and methods Our institutional database constituted a collective of 112 patients diagnosed with TTS between 2003 and 2015. The patients were classified into two groups based on the left ventricular ejection fraction (LVEF), with those presenting with a LVEF > 35% on admission categorized into one group (n = 65, 58%) and those presenting with LVEF ≤ 35% (n=47, 42%) categorized into another group. The endpoint was the all-cause of mortality over a mean follow-up of 1529 ± 1121 days. Results Preliminary results indicated that patients with an EF ≤ 35% had a significantly greater risk of developing life-threatening arrhythmias, and were much more likely to suffer from cardiogenic shock. Patients often required varying forms of mechanical respiratory support. The in-hospital mortality, 30-day mortality, 1-year mortality and ongoing long-term mortality was significantly higher in TTS patients with an EF ≤ 35%. In a multivariate Cox regression analysis, an EF ≤ 35% (HR 3·3, 95% CI: 1·2-9·2, P < 0·05) was identified as a strong independent predictor of the primary endpoint. Conclusions In-hospital events as well as short- and long-term mortality rates among TTS patients diagnosed with a significantly reduced LVEF on admission were significantly higher. There is an urgent need for randomized trials, which could help define uniform clinical management strategies for high risk TTS patients.