[Clinical spectrum of tako-tsubo cardiomyopathy in Germany: results of the tako-tsubo registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)].
BACKGROUND
Tako-tsubo cardiomyopathy (TTC) was first described in 1990 in Japan. A TTC registry was initiated by the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK) in order to evaluate the clinical spectrum and the management of patients with this syndrome in Germany.


METHODS
Patients from 37 hospitals were included in the registry if they fulfilled the following criteria: 1. acute chest symptoms or syncope, 2. new ischemic ECG changes with ST-segment elevation ± T-wave inversion, 3. reversible left ventricular regional wall motion abnormality not corresponding to a single coronary artery territory, 4. absence of significant coronary artery stenoses.


RESULTS
296 of the 324 patients (age 68 ±  12) were women (91 %) and 28 men (9 %). Leading symptoms were angina pectoris (72 %), dyspnoea (16 %), syncope (3 %) or resuscitation/cardiogenic shock (2 %). An antecedent trigger was found in 77  %. Time from symptom onset to hospital admission was 7,6  ±  6,9 hours. An acute coronary syndrome (ACS) was clinically suspected in 87 %. The ECG showed ST-segment elevation in 85 %. Cardiac troponin was elevated in more than 90 % of patients. Left ventricular ejection fraction by angiography was reduced to 49 ± 14 %. Initial medical treatment corresponded to the working diagnosis of an ACS. Catecholamines or an intraaortic balloon pump were necessary in 5 % and 1 %, respectively. Seven patients (2.2 %) died in hospital.


CONCLUSIONS
TTC afflicts mainly women and presents clinically as an ACS in 87 %. Hospital mortality is low with symptomatic therapy.
Schneider
B
B
Klinik für Kardiologie, Sana Kliniken Lübeck GmbH, Lübeck. b.schneider@sana-luebeck.de
Athanasiadis
A
A
Schwab
J
J
Pistner
W
W
von Scheidt
W
W
Gottwald
U
U
Schamberger
R
R
Schoeller
R
R
Bublak
A
A
Toepel
W
W
Winter
K D
KD
Sechtem
U
U
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003402:Creatine Kinase / Q000097:blood; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D020107:Troponin T / Q000097:blood
D020107:Troponin T; D003402:Creatine Kinase