Takotsubo Cardiomyopathy: Another Form of Cardiorenal Syndrome

Angiology. 2018 Feb;69(2):130-135. doi: 10.1177/0003319717718978. Epub 2017 Jul 10.

Abstract

Takotsubo cardiomyopathy (TC) is a life-threatening syndrome with ambiguous pathophysiology. The interdependency between heart failure and kidney failure (KF) is well established, but the influence of KF on TC outcome is not known. This single-center cohort from January 2003 to September 2015 consisted of 114 consecutive patients with TC. They were divided into 2 groups according to the presence (n = 32, 29.6%) or absence (n = 76, 70.3%) of KF. The end point of this retrospective study was a composite of in-hospital events, all-cause mortality, rehospitalization due to heart failure, stroke, and recurrence of TC (mean follow-up: 5 years). Although there were no differences in baseline characteristics between patients with/without KF, we found a significantly higher mortality rate in those with KF, 1 (7.9% vs 21.8%, P < .05), 2 (11.8% vs 31.5%, P < .05), and 5 years (22.3% vs 43.7%, P < .05) after the index event. There were no differences in life-threatening arrhythmias, cardiogenic shock, cardiopulmonary resuscitation, and thromboembolic events in both groups at the index event. Patients with TC and KF have a much worse long-term prognosis. This is clinically relevant, but the mechanisms responsible remain to be determined.

Keywords: Takotsubo cardiomyopathy; Takotsubo predisposing factors; acute left ventricular dysfunction; kidney failure; mortality.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardio-Renal Syndrome / diagnosis
  • Cardio-Renal Syndrome / therapy*
  • Female
  • Heart Failure / mortality
  • Hospital Mortality
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Shock, Cardiogenic / diagnosis
  • Shock, Cardiogenic / therapy
  • Stroke Volume / physiology
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / therapy*
  • Time