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The Impact of Stressor Patterns on Clinical Features in Patients With Tako-tsubo Cardiomyopathy: Experiences of 2 Tertiary Cardiovascular Centers.
MedLine Citation:
PMID:  23027688     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Tako-tsubo cardiomyopathy (TTC) is typically triggered by an acute emotional or physical stress event. The aim of this study was to investigate the impact of stressor patterns on clinical features, laboratory parameters, and electrocardiographic and echocardiographic findings in patients with TTC. HYPOTHESIS: Methods: Of 137 patients enrolled from the TTC registry database, 14 patients had emotional triggers (E group), 96 had physical triggers (P group), and 27 had no triggers (N group). RESULTS: Most clinical presentations and in-hospital courses were similar among the groups. However, the E group had a higher prevalence of chest pain (P = 0.006) and palpitation (P = 0.006), whereas the P group had a higher prevalence of cardiogenic shock (P = 0.040), than other groups. The P group had a significantly higher heart rate (P = 0.001); higher high-sensitivity C-reactive protein (P = 0.006), creatine kinase MB fraction (P = 0.045), and N terminal-probrain natriuretic peptide (P = 0.036) levels; higher left ventricular end-diastolic pressure (P = 0.019) and left ventricular end-systolic diameter (P = 0.002); but lower left ventricular ejection fraction (P = 0.018). The E group had lesser prevalence of apical ballooning pattern (P = 0.038) than other groups. The P group required more frequent use of inotropics (P = 0.041) and diuretics (P = 0.047) and had significantly longer intensive care unit (P = 0.014) and in-hospital stays (P = 0.001). CONCLUSIONS: The clinical features of TTC are different according to preceding stressor patterns. The TTC group with preceding physical stressors was less likely to have preserved cardiovascular reserve and more likely to require hemodynamic support than other groups. The overall prognosis of TTC is excellent, regardless of triggering stressors. The authors have no funding, financial relationships, or conflicts of interest to disclose.
Authors:
Bong Gun Song; Hyun Suk Yang; Hweung Kon Hwang; Gu Hyun Kang; Yong Hwan Park; Woo Jung Chun; Ju Hyeon Oh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-1
Journal Detail:
Title:  Clinical cardiology     Volume:  -     ISSN:  1932-8737     ISO Abbreviation:  Clin Cardiol     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Wiley Periodicals, Inc.
Affiliation:
Division of Cardiology, Cardiac and Vascular Center, Department of Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
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