Early β-blocker use and in-hospital mortality in patients with Takotsubo cardiomyopathy

Isogai, Toshiaki; Matsui, Hiroki; Tanaka, Hiroyuki; Fushimi, Kiyohide; Yasunaga, Hideo

doi:10.1136/heartjnl-2015-308712

Cited by 111 publications

(89 citation statements)

References 32 publications

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“…Equally there is no medication that is able to prevent recurrences or to mitigate the symptoms that a proportion of these patients continue to experience34 after they recover from their acute illness. Retrospective registry data suggest that beta-blockers are not useful in preventing acute in-hospital mortality43 or recurrences. However, randomised clinical trials with prespecified end-points in takotsubo have not taken place and remain premature until a more clear mechanism of disease is elucidated in humans.…”

Section: The Aftermath Of a Takotsubo Episodementioning

confidence: 99%

Acute stress-induced (takotsubo) cardiomyopathy

Dawson

2017

Heart

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Acute stress-induced (takotsubo) cardiomyopathy has a dramatic clinical presentation, mimicking an acute myocardial infarction and is triggered by intense emotional or physical stress. In this paper, we review the current state of knowledge of the mechanistic physiology underlying the left ventricular ballooning. The pathophysiology of the recovery from this acute heart failure syndrome is presented. The short-term and long-term outlook puts this new syndrome on a different perspective compared with recently held views. Current knowledge on susceptibility and predisposition already define distinctive characteristics of patients with takotsubo compared with myocardial infarction. Gaps in knowledge and future directions of research are identified in order to best direct efforts for identifying specific therapies for this condition, in the acute setting, to mitigate postacute symptoms or to prevent recurrences, none of which exist.

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Section: The Aftermath Of a Takotsubo Episodementioning

confidence: 99%

Acute stress-induced (takotsubo) cardiomyopathy

Dawson

2017

Heart

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“…53 Many advocate anticoagulation in cases where LV thrombi are detected or support anticoagulation in all patients until the akinetic wall motion abnormalities have resolved. 26 A repeat echocardiography is advisable before hospital discharge as well as follow-up one to six months afterward.…”

Section: Managementmentioning

confidence: 99%

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

Hessel

2016

Can J Anesth/J Can Anesth

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“…In addition, cardiogenic shock patients had higher incidence of significant mitral regurgitation and LVEDP, likely as a consequence of the underlying systolic dysfunction and LVOTO (5) The role of early β-blocker in TCM has been controversial. Their use in cardiogenic shock associated with LVOTO has been suggested to allow better diastolic relaxation, better forward flow and improvement in systolic pressure (2,27,28), conversely, their role in improving short term mortality has been questioned recently (29). Similarly, the use of β-blockers to prevent recurrence has not been proven beyond doubt (2,25,30,31).…”

Section: Discussionmentioning

confidence: 99%

Estimation of Risk Factors for Cardiogenic Shock in Takotsubo Cardiomyopathy: A Retrospective Study

Vaidya

Madhira

2017

ICFJ

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Introduction: Presentation of Takotsubo cardiomyopathy(TCM) widely varies amongst the patients, ranging from asymptomatic patients to cardiogenic shock or even cardiac arrest. The underlying risk factors inherent to the patient that predispose to a catastrophic presentation have not been delineated well in the past.Objective: To distinguish risk factors and presenting characteristics of patients diagnosed with cardiogenic shock from TCM.Methods: Total 51 angiography-confirmed TCM patients admitted in Upstate Hospital from 2010 – 2014 were compared retrospectively, 13 presenting with cardiogenic shock.Results: While TCM was predominantly common in elderly females, four of the total six male TCM patients presented with shock (Odds ratio= 8.0, p=0.027). TSH was higher in cardiogenic shock group. Patients with shock had significantly higher incidence of ST elevations on EKG and higher peak troponins. Moreover, ST elevations were predominantly in the inferior, anteroseptal and lateral leads in the shock group as compared to only the septal leads in the control group. Echocardiography revealed lower LV ejection fraction, LV outflow tract obstruction and concomitant significant mitral regurgitation in shock patients. No correlation was found with age, BMI, coronary disease risk factors (diabetes, hypertension, smoking), coincident infection, electrolyte imbalance, QTc interval length.Conclusion: Risk factors and pathophysiology for cardiogenic shock in TCM were identified. TCM in males is rare, but male gender is a risk factor for shock.

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Early β-blocker use and in-hospital mortality in patients with Takotsubo cardiomyopathy

Abstract: This study found no significant association between early β-blocker use and in-hospital mortality in patients with TC.

Cited by 111 publications

References 32 publications

Acute stress-induced (takotsubo) cardiomyopathy

Acute stress-induced (takotsubo) cardiomyopathy

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review

Estimation of Risk Factors for Cardiogenic Shock in Takotsubo Cardiomyopathy: A Retrospective Study

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