In the 25 years since first being described, takotsubo (stress) cardiomyopathy has gained increasing recognition as a common clinical entity.\u00a0 Despite this, our understanding of the natural history of takotsubo cardiomyopathy remains limited.\u00a0 The International Takotsubo Registry has been gathering data on takotsubo cases since 1998 and this publication describes their findings to date.\u00a0 Among 1,750 patients with takotsubo cardiomyopathy, 90% were women, the mean age was 66.8 years, and psychiatric or neurological disorders were common (56%). Approximately one-quarter of presentations were triggered by an emotional event, slightly more than one-third by a physical event, and the remainder had no identified trigger. Rates of in-hospital cardiogenic shock and death were similar to rates of these events in a matched cohort of patients presenting with an acute coronary syndrome.\u00a0 Predictors of in-hospital complications of takotsubo cardiomyopathy included a physical event triggering presentation, acute neurologic or psychiatric diseases, high troponin levels, and a low ejection fraction on admission.\u00a0 In follow-up, the risk of major adverse events was 9.9% per patient-year and the risk of death was 5.6% per patient-year. In this observational analysis, treatment with an ACE I or ARB was associated with significantly improved prognosis, while no effect was observed with beta-blockade.\u00a0 Rates of takotsubo recurrence were 1.8% per patient year.<\/p>\n
Conclusions: This observational study from a large registry of patients with takosubo cardiomyopathy provides important insights on the natural history of the disease and predictors of poor outcomes.\u00a0 Further research is needed to define optimal treatment strategies for this high risk patient population.<\/p>\n
Summarized by Hussain Contractor and Steven M. Bradley<\/p>\n
Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, Cammann VL, Sarcon A, Geyer V, Neumann CA, Seifert B, Hellermann J, Schwyzer M, Eisenhardt K, Jenewein J, Franke J, Katus HA, Burgdorf C, Schunkert H, Moeller C, Thiele H, Bauersachs J, Tsch\u00f6pe C, Schultheiss HP, Laney CA, Rajan L, Michels G, Pfister R, Ukena C, B\u00f6hm M, Erbel R, Cuneo A, Kuck KH, Jacobshagen C, Hasenfuss G, Karakas M, Koenig W, Rottbauer W, Said SM, Braun-Dullaeus RC, Cuculi F, Banning A, Fischer TA, Vasankari T, Airaksinen KE, Fijalkowski M, Rynkiewicz A, Pawlak M, Opolski G, Dworakowski R, MacCarthy P, Kaiser C, Osswald S, Galiuto L, Crea F, Dichtl W, Franz WM, Empen K, Felix SB, Delmas C, Lairez O, Erne P, Bax JJ, Ford I, Ruschitzka F, Prasad A, L\u00fcscher TF. Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy. N Engl J Med. 2015 Sep 3;373(10):929-38.<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
In the 25 years since first being described, takotsubo (stress) cardiomyopathy has gained increasing recognition as a common clinical entity.\u00a0 Despite this, our understanding of the natural history of takotsubo cardiomyopathy remains limited.\u00a0 The International Takotsubo Registry has been gathering data on takotsubo cases since 1998 and this publication describes their findings to date.\u00a0 Among […]<\/p>\n