| Title: |
Long-term outcome in patients with Takotsubo syndrome presenting with severely reduced left ventricular ejection fraction |
| Authors: |
Citro, Rodolfo; Radano, Ilaria; Parodi, Guido; Di Vece, Davide; Zito, Concetta; Novo, Giuseppina; Provenza, Gennaro; Bellino, Michele; Prota, Costantina; Silverio, Angelo; Antonini-Canterin, Francesco; Rigo, Fausto; Vriz, Olga; Galasso, Gennaro; Bossone, Eduardo; Salerno-Uriarte, Jorge; Piscione, Federico |
| Contributors: |
Citro, Rodolfo*; Radano, Ilaria; Parodi, Guido; Di Vece, Davide; Zito, Concetta; Novo, Giuseppina; Provenza, Gennaro; Bellino, Michele; Prota, Costantina; Silverio, Angelo; Antonini-Canterin, Francesco; Rigo, Fausto; Vriz, Olga; Galasso, Gennaro; Bossone, Eduardo; Salerno-Uriarte, Jorge; Piscione, Federico |
| Publisher Information: |
John Wiley and Sons Ltd |
| Publication Year: |
2019 |
| Collection: |
IRIS Università degli Studi di Palermo |
| Subject Terms: |
Cardiogenic shock; Cardiomyopathy; Heart failure; Left ventricular ejection fraction; Takotsubo syndrome; Cardiology and Cardiovascular Medicine |
| Description: |
Aim: To evaluate the long-term outcome of patients with Takotsubo syndrome (TTS) and severely reduced left ventricular ejection fraction (LVEF ≤ 35%) at presentation. Methods and results: The study population included 326 patients (mean age 69.5 ± 10.7 years, 28 male) with TTS enrolled in the Takotsubo Italian Network, divided into two groups according to LVEF (≤ 35%, n = 131; > 35%, n = 195), as assessed by transthoracic echocardiography at hospital admission. In-hospital events were recorded in both groups. At long-term follow-up (median 26.5 months, interquartile range 18–33), composite major adverse cardiac events (MACE: cardiac death, acute myocardial infarction, heart failure, and TTS recurrence) and rehospitalization were investigated. Compared to patients with LVEF > 35%, patients with LVEF ≤ 35% were older (71.2 ± 10.8 vs. 68.4 ± 10.6 years; P = 0.026) and experienced more frequently cardiogenic shock (16% vs. 4.6%; P < 0.001), acute heart failure (28.2% vs. 12.8%; P = 0.001), and intra-aortic balloon pump support (11.5% vs. 2.6%; P = 0.001) in the acute phase. At long-term follow-up, higher rates of composite MACE (25.2% vs. 10.8%; P = 0.001) and rehospitalization for cardiac causes (26% vs. 13.3%; P = 0.004) were observed in these patients. LVEF ≤ 35% at admission [hazard ratio (HR) 2.184, 95% confidence interval (CI) 1.231–3.872; P = 0.008] and age (HR 1.041, 95% CI 1.011–1.073; P = 0.006) were independent predictors of MACE. Patients with LVEF ≤ 35% also had a significant lower freedom from composite MACE during long-term follow-up (χ2 = 11.551, P = 0.001). Conclusion: Left ventricular ejection fraction ≤ 35% at presentation is a key parameter to identify TTS patients at higher risk not only in the acute phase but also at long-term follow-up. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/30714660; info:eu-repo/semantics/altIdentifier/wos/WOS:000472578900012; volume:21; issue:6; firstpage:781; lastpage:789; numberofpages:9; journal:EUROPEAN JOURNAL OF HEART FAILURE; https://hdl.handle.net/10447/354542 |
| DOI: |
10.1002/ejhf.1373 |
| Availability: |
https://hdl.handle.net/10447/354542; https://doi.org/10.1002/ejhf.1373 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.91E7C680 |
| Database: |
BASE |