| Natural history of tako-tsubo cardiomyopathy. | |
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MedLine Citation:
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PMID: 20884730 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Stress-induced or tako-tsubo cardiomyopathy (TTC) is a rare acute cardiac syndrome characterized by transient left ventricular (LV) dysfunction of uncertain cause and outcome. This study sought to assess the long-term outcome of patients with TTC. METHODS: One-hundred sixteen consecutive patients were prospectively included in the study and observed at long-term follow-up. Primary end points were death, TTC recurrence, and hospitalization from any cause. RESULTS: Mean initial LV ejection fraction (LVEF) at admission was 36% ± 9%. Two patients died of refractory heart failure during hospitalization. Of the patients who were discharged alive all except one showed complete LV functional recovery. At follow-up (2.0 ± 1.3 years), only 64 (55%) patients were asymptomatic. Rehospitalization rate was high (25%), with chest pain (n = 6) and dyspnea (n = 5) as the most common causes. Only two patients had a recurrence of TTC. Eleven patients died (seven from cardiovascular cause). There was no significant difference in mortality (12% vs 7%; P = .284) and in the other clinical events between patients with and without severe LV dysfunction at presentation (LVEF ≤ 35%). Mortality observed in patients with TTC was compared with age and sex-specific mortality of the general population using the standardized mortality ratio (SMR) method. The SMR was 3.40 (95% CI, 1.83-6.34) in the TTC population. The only independent predictor of death at Cox analysis was Charlson comorbidity index (hazard ratio, 1.786; P = .0001), but the degree of initial LV dysfunction was not an independent predictor of death. CONCLUSIONS: The recurrence of TTC is rare, but recurrences of chest pain or dyspnea are common in patients with TTC and frequently lead to hospital readmission. Long-term mortality is higher as compared with the control general population and at least in part related to patients' comorbidities. Initial LV dysfunction severity does not seem to impact long-term event rates. |
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Authors:
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Guido Parodi; Benedetta Bellandi; Stefano Del Pace; Alessandro Barchielli; Linda Zampini; Silvia Velluzzi; Nazario Carrabba; Gian Franco Gensini; David Antoniucci; |
Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-09-30 |
Journal Detail:
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Title: Chest Volume: 139 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-04-06 Completed Date: 2011-06-07 Revised Date: 2011-11-08 |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 887-92 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Careggi Hospital, University of Florence, Florence, Italy. parodiguido@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Female Follow-Up Studies Hospitalization / statistics & numerical data* Humans Italy / epidemiology Male Prospective Studies Recurrence Survival Rate / trends Takotsubo Cardiomyopathy / etiology*, mortality, physiopathology Time Factors Ventricular Function, Left / physiology* |
| Comments/Corrections | |
Comment In:
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Chest. 2011 Oct;140(4):1101; author reply 1101-2
[PMID:
21972395
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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