Clinical presentation, treatment, and long-term outcomes in patients with takotsubo cardiomyopathy. Experience of a single cardiology center.
BACKGROUND
Takotsubo cardiomyopathy (TTC) is a rare transient cardiomyopathy mimicking acute coronary syndrome (ACS).


OBJECTIVE
The aim of the study was to retrospectively analyze the clinical course, treatment strategies, and follow-up of patients with TTC.


METHODS
Among all patients hospitalized in the department between January 2005 and January 2010, we identified a group of patients who were fulfilling the modified Mayo Clinic criteria for the diagnosis of TTC. Clinical presentation, hospital course, and clinical outcomes were analyzed.


RESULTS
A total of 31 patients with TTC were included into the study; women comprised 93.5% of the study population. The most common symptoms included chest pain and dyspnea caused by emotional or physical stress. Cardiogenic shock was present in 2 subjects and life-threatening ventricular arrhythmias in 3 other patients. Twenty-four patients had ST-segment elevation on the electrocardiogram. A mean left ventricular ejection fraction was 42 +/-8.6% during contractility abnormalities, and it increased to 58 +/-7.9% during recovery. Troponin I was positive in 30 cases with a mean peak level of 2.7 +/-5.1 ng/ml. Follow-up data were available in 23 patients and a mean follow-up was 955 +/-502.8 days. We did not observe a recurrence of TTC.


CONCLUSIONS
TTC is observed mainly in postmenopausal women. Clinical presentation of TTC is almost indistinguishable from ACS, but its course is milder and the outcomes are better.
Opolski
Grzegorz
G
1st Department of Cardiology, Medical University of Warsaw, Independent Public Central Clinical Hospital, Warszawa, Poland. grzegorz.opolski@wum.edu.pl
Pawlak
Maciej M
MM
Roik
Marek F
MF
Kochanowski
Janusz
J
Scisło
Piotr
P
Piatkowski
Radosław
R
Kochman
Janusz
J
Karpiński
Grzegorz
G
Kowalik
Robert
R
Grabowski
Marcin
M
Balsam
Paweł
P
Filipiak
Krzysztof J
KJ
D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome