Comparison and Outcome Analysis of Patients with Takotsubo Cardiomyopathy Triggered by Emotional Stress or Physical Stress

Abstract

Background: Previous studies revealed that takotsubo cardiomyopathy (TTC) is triggered by physical and emotional stresses. This study was performed to determine the short- and long-term prognostic impact of emotional- and physical stress associated with TTC.Methods and results: Our institutional database constituted a collective of 84 patients diagnosed with TTC between 2003 and 2015. The patients were divided into two groups as per the presence of emotional stress (n = 24, 21%) or physical stress (n = 60, 52.6%). The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), myocardial infarction, all-cause of mortality, re-hospitalization due to heart failure, stroke, and recurrence of TTC. A Kaplan–Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 5 years in the emotional group than the physical stress group (log-rank, p < 0.01). Multivariate Cox regression analysis revealed only emotional stress (HR 0.4, 95% CI: 0.2–0.9, p < 0.05) as a negative independent predictor of the primary endpoint.Conclusion: Rates of in-hospital events and short- as well as long-term events were significantly lower in TTC patients suffering from emotional stress as compared to patients with physical stress.

Takotsubo Cardiomyopathy—Acute Cardiac Dysfunction Associated With Neurological and Psychiatric Disorders

“…Interestingly, data derived from the International Takotsubo Registry revealed patients characteristics with TTC in the United States and Europe and showed that of 1,750 studied patients diagnosed with TTC 89.8% were postmenopausal women with a mean age of 66.8 years (5, 6). Importantly, higher in-hospital mortality rates of male TTC patients compared to female TTC patients have been observed retrospectively (11, 12). However, Patel et al found in their analysis no significant sex difference in respect of overall mortality rates of TTC patients aged ≥50 years (11).…”

Cardiac arrhythmias and In-hospital mortality amongst patients with takotsubo cardiomyopathy: A retrospective study in an Italian population

“…Atrial arrhythmias, on the other hand were prevalent in our study population, comprising 10.0% of the overall cohort. A recent metanalysis described the prevalence of atrial fibrillation in TTC ranging from 8.4 to 25.0%, depending upon the average age of the study population [15] , [25] , [26] , [27] , [28] , [29] . Acutely, atrial arrhythmias in TTC is thought to be the result of left atrial dysfunction as well as from a catecholaminergic surge [14] , [30] .…”

Mortalidade Cardiovascular Associada ao Rastreamento Mamográfico

“…Outra possível causa seria a miocardiopatia de Takotsubo, também chamada de miocardiopatia induzida por estresse, de insuficiência cardíaca aguda relativamente pouco conhecida. Ela mimetiza o diagnóstico de infarto agudo do miocárdio, sendo o diagnóstico final de 2% dos casos inicialmente atendidos com síndrome coronariana aguda 24 . A miocardiopatia de Takotsubo apresenta episódios de estresse psicológico como fator precipitante em cerca de 30% dos casos, sendo mais comum em mulheres e, assim como o câncer de mama, afeta predominantemente mulheres na pós-menopausa 24 .…”