| Title: |
Clinical Characteristics and Outcomes of Patients With Takotsubo Syndrome Complicated With Acute Mitral Regurgitation |
| Authors: |
Silverio, Angelo; Bellino, Michele; Bossone, Eduardo; Aleksova, Aneta; Di Vece, Davide; Cameli, Matteo; Cristiano, Mario; Parodi, Guido; Musumeci, Giuseppe; Migliarino, Serena; Scudiero, Fernando; Innelli, Pasquale; Vriz, Olga; Rigo, Fausto; Pucci, Martina; Attisano, Tiziana; Di Maio, Marco; Zito, Concetta; Novo, Giuseppina; Galasso, Gennaro; Sinagra, Gianfranco; Vecchione, Carmine; Citro, Rodolfo |
| Contributors: |
Silverio, Angelo; Bellino, Michele; Bossone, Eduardo; Aleksova, Aneta; Di Vece, Davide; Cameli, Matteo; Cristiano, Mario; Parodi, Guido; Musumeci, Giuseppe; Migliarino, Serena; Scudiero, Fernando; Innelli, Pasquale; Vriz, Olga; Rigo, Fausto; Pucci, Martina; Attisano, Tiziana; Di Maio, Marco; Zito, Concetta; Novo, Giuseppina; Galasso, Gennaro; Sinagra, Gianfranco; Vecchione, Carmine; Citro, Rodolfo |
| Publication Year: |
2026 |
| Collection: |
Università degli studi di Trieste: ArTS (Archivio della ricerca di Trieste) |
| Subject Terms: |
acute mitral regurgitation; broken heart syndrome; left ventricular outflow tract obstruction; stress cardiomyopathy; takotsubo syndrome |
| Description: |
Background: Acute mitral regurgitation (MR) is a serious complication of takotsubo syndrome (TTS). However, its incidence and prognostic implications are still poorly investigated. Objectives: This study aimed to assess the clinical characteristics, short- and long-term outcomes of patients with TTS complicated by acute, reversible, moderate or severe MR. Methods: The study included TTS patients from the Takotsubo Italian Network multicenter registry. The primary outcome was the composite of in-hospital acute heart failure, cardiogenic shock, and mortality. Secondary outcomes included mortality and the recurrence of TTS at the longest available follow-up. The propensity score weighting technique was performed to account for potential confounders between patients with and without acute moderate or severe MR. Results: The study included 1,025 patients (mean age 70 ± 11 years, 91.6% females); of them, 186 (18.2%) showed acute moderate or severe MR. Logistic regression analysis showed a significantly higher risk for the primary outcome (adjusted OR: 2.29; 95% CI: 1.83-2.88), acute heart failure (adjusted OR: 2.17; 95% CI: 1.70-2.77), and cardiogenic shock (adjusted OR: 2.46; 95% CI: 1.69-3.59) in patients with acute MR compared to those without. Also, the coexistence of left ventricular outflow tract obstruction with acute MR further increased the risk for the primary outcome (adjusted OR: 5.26; 95% CI: 3.22-8.59). At long-term follow-up (median 29 months), patients who developed acute MR during hospitalization showed a significantly higher risk of mortality (adjusted HR: 1.82; 95% CI: 1.21-2.74). Conclusions: In this real-world study, acute MR was associated with a significantly higher risk of adverse events during hospitalization and long-term mortality. Early echocardiographic detection of acute MR can support prognostic stratification and management of TTS patients. |
| Document Type: |
article in journal/newspaper |
| File Description: |
ELETTRONICO |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/41564735; info:eu-repo/semantics/altIdentifier/wos/WOS:001676240800001; volume:5; issue:2; firstpage:"-"; lastpage:"-"; numberofpages:11; journal:JACC. ADVANCES; https://hdl.handle.net/11368/3124301; https://www.sciencedirect.com/science/article/pii/S2772963X25009512?via=ihub |
| DOI: |
10.1016/j.jacadv.2025.102522 |
| Availability: |
https://hdl.handle.net/11368/3124301; https://doi.org/10.1016/j.jacadv.2025.102522; https://www.sciencedirect.com/science/article/pii/S2772963X25009512?via=ihub |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license:Digital Rights Management non definito ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/ ; license uri:iris.PRI00 |
| Accession Number: |
edsbas.34E7C9D7 |
| Database: |
BASE |