title: Long-term prognosis of the transient left ventricular dysfunction syndrome (Tako-Tsubo cardiomyopathy): focus on malignancies.
abstract: BACKGROUND
  The pathophysiology and long-term prognosis of the transient left ventricular dysfunction syndrome (LVDS, Tako-Tsubo cardiomyopathy) is largely unknown.
  
  
  OBJECTIVE
  To investigate the prevalence of malignancies and long-term mortality in patients with LVDS.
  
  
  RESULTS
  Fifty patients with LVDS (47 females and 3 men, age 70+/-10 years) and 50 age- and gender-matched control patients with acute anterior myocardial infarction (MI) were evaluated. Nine patients (18%) with LVDS and 3 patients (6%) with MI had a previous history of malignancy at the time of the index event. On follow-up (2.9+/-1.6 years), 7 malignancies were newly diagnosed in the LVDS cohort whereas no new case of malignancy was found in the control group (p=0.01, odds ratio 16.95, 95% confidence interval [CI] 1.93-304.60). Overall mortality during follow-up did not differ significantly between both groups (hazard ratio 1.44 for death in LVDS patients, 95% CI 0.52-3.95, p=0.49); however, of those patients who died, cardiac deaths were more frequent in patients with MI (100% versus 11% in patients with LVDS, p<0.001).
  
  
  CONCLUSIONS
  Our data suggest an association of LVDS with malignancies, potentially as a result of paraneoplastic phenomena. Long-term prognosis of patients with LVDS is no better than in patients with acute MI.
authors.affiliation: Department of Internal Medicine II, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany. christof.burgdorf@uk-sh.de
authors.forename: Christof
authors.initials: C
authors.lastname: Burgdorf
authors.forename: Volkhard
authors.initials: V
authors.lastname: Kurowski
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bonnemeier
authors.forename: Heribert
authors.initials: H
authors.lastname: Schunkert
authors.forename: Peter Walter
authors.initials: PW
authors.lastname: Radke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology