Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Takotsubo Syndrome
Incomplete Recovery From Takotsubo Syndrome Is a Major Determinant of Cardiovascular Mortality
Kensuke Matsushita, Lucie Lachmet-Thébaud, Benjamin Marchandot, Antonin Trimaille, Chisato Sato, Charlotte Dagrenat, Stephane Greciano, Fabien De Poli, Pierre Leddet, Marilou Peillex, Sébastien Hess, Adrien Carmona, Charline Jimenez, Joe Heger, Antje Reydel, Patrick Ohlmann, Laurence Jesel, Olivier Morel
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Keywords: Ejection fraction, Iinflammation, Mortality, Takotsubo syndrome
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2021 Volume 85 Issue 10 Pages 1823-1831

Editorial (85-10 pp. 1832-1833)
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Abstract

Background:Although there is an apparent rapid and spontaneous recovery of left ventricular ejection fraction (LVEF) in patients with Takotsubo syndrome (TTS), recent studies have demonstrated a long-lasting functional impairment in those patients. The present study sought to evaluate the predictors of incomplete recovery following TTS and its impact on cardiovascular mortality.

Methods and Results:Patients with TTS between 2008 and 2018 were retrospectively enrolled at 3 different institutions. After exclusion of in-hospital deaths, 407 patients were split into 2 subgroups according to whether their LVEF was >50% (recovery group; n=341), or ≤50% (incomplete recovery group; n=66) at the chronic phase. Multivariate logistic regression analysis found that LVEF (odds ratio [OR]: 0.94; 95% confidence interval [CI]: 0.91–0.98; P<0.001) and C-reactive protein levels (OR: 1.11; 95% CI: 1.02–1.22; P=0.02) at discharge were independent predictors of incomplete recovery. At a median follow up of 52 days, a higher cardiovascular mortality was evident in the incomplete recovery group (16% vs. 0.6%; P<0.001).

Conclusions:This study demonstrated that incomplete recovery after TTS is characterized by residual systemic inflammation and an increased cardiac mortality at follow up. Altogether, the present study findings determined that patients with persistent inflammation are a high-risk subgroup, and should be targeted in future clinical trials with specific therapies to attenuate inflammation.

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© 2021, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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