Document Detail


Takotsubo cardiomyopathy and QT interval prolongation: who are the patients at risk for torsades de pointes?
MedLine Citation:
PMID:  19261294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: QT interval prolongation is prevalent among patients with Takotsubo cardiomyopathy (TC), whereas torsades de pointes (TdP) has rarely been reported in these patients. We studied all peer-reviewed reports on TC-associated QT interval prolongation and all peer-reviewed reports on TC-associated TdP to characterize the clinical circumstances leading to TdP in patients with TC. METHODS: The literature search yielded 14 reports on TC-associated TdP and 26 reports on TC-associated QT interval prolongation. Overall, 15 patients with TC-associated TdP and 86 patients with TC-associated QT interval prolongation were reported. We systematically reviewed each report and recorded the risk factors for TdP as well as the clinical circumstances of TC. RESULTS: The prevalence of the male sex was higher among patients with TC-associated TdP relative to patients with TC-associated QT interval prolongation (26.7% vs 5.8%; P = .01). There was a trend in the mean maximal corrected QT interval being longer among patients with TC-associated TdP relative to patients with TC-associated QT interval prolongation (679.9 +/- 230.6 vs 555.9 +/- 63.8 milliseconds; P = .06). There were no differences between patients with TC-associated TdP and patients with TC-associated QT interval prolongation in mean age, maximal troponin levels, and lowest ejection fraction. Overall, 12 (80.0%) patients with TC-associated TdP had risk factors for TdP other than the female sex and systolic dysfunction, including suspicion of congenital long QT syndrome, bradycardia, hypokalemia, recent conversion from atrial fibrillation to sinus rhythm, and using QT prolonging agents. CONCLUSIONS: Men with TC-associated QT interval prolongation are at risk for TdP. Most patients with TC-associated TdP have risk factors for TdP other than the female sex and systolic dysfunction.
Authors:
Liat Samuelov-Kinori; Michael Kinori; Yevgeni Kogan; Michael Swartzon; Hadas Shalev; Daniel Guy; Fotini Ferenidou; Noa Mashav; Ben Sadeh; Lihi Atzmony; Orit Kliuk-Ben-Basat; Arie Steinvil; Dan Justo
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Publication Detail:
Type:  Journal Article; Meta-Analysis     Date:  2009-03-03
Journal Detail:
Title:  Journal of electrocardiology     Volume:  42     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-09-03     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  353-357.e1     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine D, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Comorbidity
Electrocardiography / statistics & numerical data*
Humans
Incidence
Long QT Syndrome / diagnosis*,  epidemiology*
Risk Assessment / methods
Risk Factors
Takotsubo Cardiomyopathy / diagnosis*,  epidemiology*
Torsades de Pointes / diagnosis*,  epidemiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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