<p>Impact of ST-segment elevation on the outcome of Takotsubo syndrome</p>

Abstract

BackgroundRecent studies have highlighted that Takotsubo syndrome (TTS), mimicking acute coronary syndrome (ACS), is associated with poor clinical outcome. TTS is associated with different repolarization disorders including ST-segment elevation. ST elevation myocardial infarction (STEMI) in ACS is associated with declined prognosis. However, the clinical and prognostic impact of ST-segment elevation on TTS remains lacking.AimThe aim of this study was to determine the short- and long-term prognostic impact of ST-segment elevation on TTS patients as compared with STEMI patients.Patients and methodsOur institutional database constituted a consecutive cohort of 138 TTS patients and 138 ACS patients matched for age and sex. TTS patients (n=41) with ST-segment elevation were compared with ACS patients with ST-segment elevation (n=64).ResultsChest pain was significantly more documented in STEMI patients as compared with TTS patients (48.8% vs 78.1%; P<0.01). Cardiovascular risk factors such as diabetes mellitus (12.2% vs 29.7%; P=0.02) were significantly more presented in STEMI patients. Although the initial left ventricular ejection fraction (LVEF) was more declined in TTS patients (39%±9% vs 45%±16%; P<0.01), the LVEF was more declined in STEMI patients at follow-up (54%±10% vs 45%±16%; P=0.04). Inhospital complications such as respiratory failure were significantly more presented in TTS patients (68.3% vs 20.3%; P<0.01). The short-term as well as the long-term morality was similar in both groups. In univariate analysis, male sex, ejection fraction (EF) <35%, glomerular filtration rate (GFR) <60 mL/min, cardiogenic shock, inotropic drugs, and history of cancer were predictors of 5-year mortality.ConclusionRates of the long-term mortality in TTS patients with ST elevations are comparable with STEMI patients.

Implications of Left Bundle Branch Block in Takotsubo Cardiomyopathy: Propensity Match Analysis from the National Inpatient Sample

“…The mortality rates were higher in TTC patients presenting with T-wave inversion on EKG compared to ACS patients with a similar electrocardiographic presentation [38]. Similar results were not seen in those presenting with ST-elevation on EKG [39].…”

Mechanical stress concealed force enhancement and ionic transient membrane potential and metabolism in akinesia of stress cardiomyopathy

“…H2 receptors cause distinct changes in the action potential configuration with increases in the height and duration of the plateau phase and an increase in the overall action potential duration, which are associated with cyclic AMP-mediated increases in calcium-dependent slow inward current [121] . A limited release of cardiac markers was disproportionate to the extent of akinesia [22] .…”

ECG differences and ECG predictors in patients presenting with ST segment elevation due to myocardial infarction versus takotsubo syndrome

“…The occurrence of ventricular arrhythmia or death in STE-TS versus STEMI has only been investigated in a few small cohorts [8] , [9] . Furthermore, to what extent ECG predictors of outcome differs between STE-TS and STEMI is largely unknown.…”