TY - JOUR
T1 - Prevalence of diastolic function and clinical impact on long-term outcome in takotsubo cardiomyopathy
AU - Sun, Tao
AU - Ming, Zhang
AU - Liu, Zhi
AU - Lennon, Ryan J.
AU - Yang, Shi Wei
AU - Kwon, Taek Geun
AU - Park, Kyoung Ha
AU - Lerman, Lilach O.
AU - Lerman, Amir
N1 - Publisher Copyright:
© 2017 Elsevier Ireland Ltd
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Background Takotsubo cardiomyopathy (TTC) is a syndrome characterized by transient regional systolic dysfunction of the left ventricle (LV). However, far fewer reports focused on the prevalence of left ventricular diastolic function (DF) and its impact on an adverse prognosis in TTC. Methods From January 2005 to October 2014, 205 consecutive TTC patients (mean age, 70± 12 years; 95% female) were studied. The patients underwent transthoracic echocardiography at the acute phase and recovery phase (mean, 38 ± 16 days after admission). Results DF was labeled as normal, mild, moderate and severe. At the acute phase, Abnormal DF was present in 108 patients (53%), and left ventricular ejection fraction (LVEF) < 50% in 156 patients (76%). At the recovery phase, DF was unchanged for 104 patients (51%), 44 patients (21%) had worsened, 57 patients (28%) had improved in DF grade. 25 patients (12%) had an LVEF < 50%. During 2 years of follow-up, 34 patients developed clinical adverse events. Kaplan-Meier analysis estimated that the subgroup with unimproved DF and LVEF < 50% at recovery phase had the worst 2-year survival. In multivariable analysis, unimproved DF with LVEF < 50% and heart rate (HR) remained predictors of clinical adverse events. Conclusions The current study demonstrated that consideration of both change of DF and LVEF allows identification of subgroups with divergent long-term prognoses in patients with TTC, and may indicate the need for a different management in the high-risk TTC patients.
AB - Background Takotsubo cardiomyopathy (TTC) is a syndrome characterized by transient regional systolic dysfunction of the left ventricle (LV). However, far fewer reports focused on the prevalence of left ventricular diastolic function (DF) and its impact on an adverse prognosis in TTC. Methods From January 2005 to October 2014, 205 consecutive TTC patients (mean age, 70± 12 years; 95% female) were studied. The patients underwent transthoracic echocardiography at the acute phase and recovery phase (mean, 38 ± 16 days after admission). Results DF was labeled as normal, mild, moderate and severe. At the acute phase, Abnormal DF was present in 108 patients (53%), and left ventricular ejection fraction (LVEF) < 50% in 156 patients (76%). At the recovery phase, DF was unchanged for 104 patients (51%), 44 patients (21%) had worsened, 57 patients (28%) had improved in DF grade. 25 patients (12%) had an LVEF < 50%. During 2 years of follow-up, 34 patients developed clinical adverse events. Kaplan-Meier analysis estimated that the subgroup with unimproved DF and LVEF < 50% at recovery phase had the worst 2-year survival. In multivariable analysis, unimproved DF with LVEF < 50% and heart rate (HR) remained predictors of clinical adverse events. Conclusions The current study demonstrated that consideration of both change of DF and LVEF allows identification of subgroups with divergent long-term prognoses in patients with TTC, and may indicate the need for a different management in the high-risk TTC patients.
KW - Adverse outcome
KW - Diastolic function
KW - Takotsubo cardiomyopathy
UR - http://www.scopus.com/inward/record.url?scp=85026751695&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026751695&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.06.068
DO - 10.1016/j.ijcard.2017.06.068
M3 - Article
C2 - 28784454
AN - SCOPUS:85026751695
SN - 0167-5273
VL - 244
SP - 7
EP - 12
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -