Document Detail


Clinical characteristics and four-year outcomes of patients in the Rhode Island Takotsubo Cardiomyopathy Registry.
MedLine Citation:
PMID:  19327433     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim was to establish a registry of patients with a diagnosis of Takotsubo cardiomyopathy (TC) to help learn more about the characteristics, treatment strategies, and natural history of this disease. Data for patients with TC diagnosed from July 2004 to April 2008 at 2 major hospitals in Rhode Island were obtained. A data set was created that included baseline demographics and characteristics, hospital, course, and clinical outcomes. TC was diagnosed in 70 patients during the study period. Postmenopausal women comprised 95% of the cohort. Six patients presented with cardiogenic shock, 9 required intubation, 3 experienced sustained ventricular arrhythmias, and 1 patient died of cardiac causes. Average ejection fraction was 37% at cardiac catheterization. Troponin-I was increased in all except 1 patient. Follow-up echocardiography showed full recovery of wall motion abnormalities, with an average ejection fraction of 59%. Most patients were treated using standard cardiovascular medications for acute coronary syndrome, and 43% were discharged on warfarin therapy because of severe apical wall motion abnormalities. Univariate analysis suggested that long-term use of angiotensin-converting enzyme inhibitors before the onset of TC was protective against cardiogenic shock, sustained ventricular arrhythmia, and death. Consecutive cases grouped into different seasons showed a statistically significant spike in the occurrence of TC during the summer months. In conclusion, the acute phase of this condition may lead to critical illness and death, and use of an angiotensin-converting enzyme inhibitor may have a protective effect. Overall long-term prognosis and recovery of left ventricular function were excellent.
Authors:
Richard A Regnante; Ryan W Zuzek; Steven B Weinsier; Syed R Latif; Russell A Linsky; Hanna N Ahmed; Immad Sadiq
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study     Date:  2009-02-07
Journal Detail:
Title:  The American journal of cardiology     Volume:  103     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-30     Completed Date:  2009-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1015-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Division of Cardiology, The Miriam Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA. rregnante@lifespan.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Female
Follow-Up Studies
Heart Catheterization / methods*
Humans
Incidence
Male
Prognosis
Recovery of Function / drug effects,  physiology
Registries*
Retrospective Studies
Rhode Island / epidemiology
Severity of Illness Index
Stroke Volume / physiology
Survival Rate / trends
Takotsubo Cardiomyopathy / diagnosis,  epidemiology*,  prevention & control
Time Factors
Ventricular Function, Left / drug effects,  physiology
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

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