Patient characteristics in variable left ventricular recovery from Takotsubo syndrome

Cardiovasc Revasc Med. 2018 Apr;19(3 Pt A):247-250. doi: 10.1016/j.carrev.2017.10.002. Epub 2017 Oct 5.

Abstract

Background: Takotsubo syndrome (TTS) is a heart failure syndrome which is usually reversible. Factors associated with degree of recovery of left ventricular systolic function in TTS are poorly understood.

Materials and methods: We conducted a retrospective analysis of 90 TTS patients treated at our institution from 2006 to 2014. Patients were grouped based on recovery of left ventricular ejection fraction (LVEF) on follow-up transthoracic echocardiogram as left ventricular ejection fraction <50% (partial group) or preserved ejection fraction ≥50% (full group). Patient baseline characteristics, comorbidities, biomarkers, electrocardiography, and echocardiogram were collected. We also compared adverse events that occurred during hospitalization.

Results: In comparison to full recovery group patients (n=63), partial recovery patients (n=27) were older (76.9±13 vs. 70.6±13years; P=0.02) and had a higher prevalence of comorbid hypothyroidism (26% vs. 8%; P=0.02). A greater number of patients from the partial group were also taking levothyroxine replacement (22% vs. 3%; P=0.003). We found no significant between-group differences in type of triggering event or cardiac biomarker levels. QT interval was longer in the partial group (540.6±71msec vs. 460.7±35msec; P=0.01). Follow-up LVEF was 37.9±8% in the partial group and 58.0±4% in the full group (P<0.001). There were no statistically significant differences in length of stay or adverse events.

Conclusion: Takotsubo patients with partial myocardial recovery were older, presented with longer QT intervals, and were more likely to have comorbid hypothyroidism.

Keywords: ECG; Recovery; Takotsubo; Thyroid.

MeSH terms

  • Action Potentials
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Rate
  • Humans
  • Hypothyroidism / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Recovery of Function
  • Registries
  • Retrospective Studies
  • Stroke Volume*
  • Takotsubo Cardiomyopathy / diagnosis
  • Takotsubo Cardiomyopathy / epidemiology
  • Takotsubo Cardiomyopathy / physiopathology*
  • Takotsubo Cardiomyopathy / therapy
  • Time Factors
  • United States / epidemiology
  • Ventricular Function, Left*