Clinical and echocardiographic course in tako­tsubo cardiomyopathy: Long­term follow­up from a multicenter study

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• 作者：Javier Matabuena­ ; Gomez-Limon ; MD^a ; ¹ ; ² ; Sebastian Isaza­ ; Arana ; MD^a ; ¹ ; ² ; Juan Robledo-Carmona ; MD^b ; ² ; Edgar Alania­ ; Torres ; MD^c ; ² ; Javier Torres­ ; Llergo ; MD^c ; ² ; Juan Ignacio Valle-Racero ; BSN^a ; ² ; Francisco Lopez­ ; Pardo ; MD^a ; ² ; Angel Martinez-Martinez ; MD ; PhD^a ; ² ; Manuel Jimenez-Navarro ; MD ; PhD^b ; ² ; Jose Angel Urbano-Moral ; MD ; PhD^a ; ² ; ^{jaurbanomoral@gmail.com}
• 关键词：Echocardiography ; Electrocardiography ; Prognosis ; Systolic function ; Tako-tsubo cardiomyopathy
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：97-102
• 全文大小：508 K
• 卷排序：228

文摘

To jointly describe clinical characteristics, ECG and echocardiographic findings, and adverse cardiovascular events in patients with tako-tsubo cardiomyopathy (TC) in the long-term.MethodsLongitudinal multicenter study including retrospective analysis of clinical and ECG data, and follow-up evaluation with clinical interview, electrocardiogram and echocardiogram.ResultsData from 66 cases of TC were available for analysis of clinical and adverse cardiovascular events, and 56 of them completed the follow-up visit including electrocardiogram and echocardiogram. Most patients (97%) were asymptomatic or oligosymptomatic (NYHA I [58%] or II [39%], respectively) at follow-up (median time: 3.7 [1.8–6.6] years). The vast majority of individual QRS complex and repolarization abnormalities had disappeared (87% with no ECG abnormalities at follow-up). On echocardiography, left ventricular ejection fraction was ≥ 50% in all patients (mean: 63 ± 6%). Wall motion abnormalities were observed in 4 patients (7%; 3 with apical wall motion abnormalities and 1 with mild global hypokinesia). Long-term outcomes were as follows: 4 deaths (6%), 2 cardiovascular and 2 non-cardiovascular; no atrial fibrillation development; no stroke events; 5 acute recurrence events of TC (8%). Globally, 57 patients (86%) had a clinical course free from adverse cardiovascular events.ConclusionsAfter a long period following the admission event, patients discharged from TC remain asymptomatic or minimally symptomatic, and feature a low prevalence of both ECG and left ventricular wall motion abnormalities; moreover, the latter lead to a very mild impairment of ejection fraction. Among cardiovascular adverse events, recurrence of the TC event appears to play the most significant role.