Clinical characteristics, and laboratory and echocardiographic findings in takotsubo cardiomyopathy presenting as cardiogenic shock.
OBJECTIVE
Although takotsubo cardiomyopathy (TTC) has been reported to have an excellent clinical recovery, there are few data regarding clinical, laboratory, and echocardiographic findings in TTC presenting as cardiogenic shock. We aimed to assess the differences in these parameters between TTC presenting with and without cardiogenic shock.


METHODS
Fifty patients were enrolled from the TTC registry database and divided according to the presence of cardiogenic shock. Sixteen patients presented with cardiogenic shock as initial presentation (S group), and 34 did not (NS group).


RESULTS
The S group had a higher prevalence of dyspnea (81% vs 38%, P = .005), pulmonary edema (69% vs 29%, P = .009), and significant reversible mitral regurgitation (44% vs 15%, P = .025) than the NS group. In addition, the S group had significantly higher troponin-I (median, 8.2 vs 1.4 pg/mL; P = .043) and N-terminal prohormone brain natriuretic peptide levels (median, 8831 vs 2348 pg/mL; P = .046). During follow-up (median, 3.1 years), cardiac deaths associated with TTC itself and recurrences of TTC were not noted in both groups.


CONCLUSIONS
The S group has a higher prevalence of heart failure symptoms, significant reversible mitral regurgitation, and troponin-I and N-terminal prohormone brain natriuretic peptide levels. However, with meticulous therapeutic strategies, prognosis of this syndrome may be excellent irrespective of hemodynamic instability.
Division of Cardiology, Department of Medicine, Cardiac Imaging Center, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 135-710, Republic of Korea.
Bong Gun
BG
Song
Sung-Ji
SJ
Park
Hye Jin
HJ
Noh
Hyun Chul
HC
Jo
Jin-Oh
JO
Choi
Sang-Chol
SC
Lee
Seung Woo
SW
Park
Eun-Seok
ES
Jeon
Duk-Kyung
DK
Kim
Jae K
JK
Oh
D000368:Aged; D004417:Dyspnea / Q000209:etiology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000209:etiology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D011654:Pulmonary Edema / Q000209:etiology; D012042:Registries; D012770:Shock, Cardiogenic / Q000453:epidemiology / Q000209:etiology*; D054549:Takotsubo Cardiomyopathy / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D019210:Troponin I / Q000097:blood
D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain